bipolar disorder: a biopsychosocial overview. mdl.psych.northwestern.edu
TRANSCRIPT
![Page 1: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/1.jpg)
Bipolar Disorder: A Biopsychosocial Overview
![Page 2: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/2.jpg)
mdl.psych.northwestern.edu
![Page 3: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/3.jpg)
Source: Touched by Fire, Jamison, 1996
![Page 4: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/4.jpg)
Bipolar Disorder: Epidemiology
• Elevated suicide, divorce, work impairment, substance use
• 6th leading cause of disability worldwide (Murray & Lopez, 1996).
• Accounts for nearly half the inpatient mental health care costs in the US (Kent et al., 1995).
![Page 5: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/5.jpg)
Roadmap: A series of Questions
Four Questions about Bipolar Disorder
1. What is it?
2. What is its stigma?
3. Is there a blood test?
4. What are its treatments?
![Page 6: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/6.jpg)
Roadmap: A series of Questions
Four Questions about Bipolar Disorder
1. What is it?
2. What is its stigma?
3. Is there a blood test?
4. What are its treatments?
![Page 7: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/7.jpg)
Depression Mania
Mood disorder involving severe mood swings
![Page 8: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/8.jpg)
Severity
Cyclothymia Bipolar II Disorder Bipolar I Disorder
Erratic depressive and hypomanic symptoms
MDE and Hypomanic Episodes
Manic Episode
No MDE
No Manic Episode MDE not necessary for diagnosis
~ 2-4 percent of population has bipolar spectrum diagnosis
![Page 9: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/9.jpg)
0
10
20
30
40
50
60
Unipolar Depression
Anxiety Disorder
Schiz Personality Disorder
Subst. Abuse
Schizo-Affective
% o
f P
atie
nts
Mis
diag
nose
d Misdiagnosis of Bipolar Disorder
60
26
1817
1411
Hirschfeld, et al. J Clin Psychiatry 64: 161-174, 2003
![Page 10: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/10.jpg)
Age-of-Onset of Bipolar Disorder
Pediatric Bipolar Disorder
- 10-20% onset < 10 yo - Controversial (40-fold increase)
- Difficult to differentiate from ADHD
![Page 11: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/11.jpg)
Roadmap: A series of Questions
Four Questions about Bipolar Disorder
1. What is it?
2. What is its stigma?
3. Is there a blood test?
4. What are its treatments?
![Page 12: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/12.jpg)
- Predicts worse course and social isolation
- Limit social interactions
- Social isolation in caregivers
Grief for the Loss of the Healthy Self
![Page 13: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/13.jpg)
Roadmap: A series of Questions
Four Questions about Bipolar Disorder
1. What is it?
2. What is its stigma?
3. Is there a blood test?
4. What are its treatments?
![Page 14: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/14.jpg)
PFC PFC
Limbic Limbic
- Common to many psychiatric disorders
- Biology of positive emotion may yield cues more specific to bipolar
![Page 15: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/15.jpg)
Ventral Striatum
‘Wanting’ Circuit in the Brain
Bipolar disorder characterized by a hypersensitivity in the wanting circuit
![Page 16: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/16.jpg)
Reward-Processing in Bipolar Disorder
![Page 17: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/17.jpg)
Reward-Related Brain Activity: MDD < Comparison
Forbes et al., 2009, Am J Psychiatry
Comparison MDD
-Bipolar disorder and unipolar depression characterized by distinct profiles in the wanting or reward circuit
-Biomarkers and treatment
![Page 18: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/18.jpg)
Roadmap: A series of Questions
Four Questions about Bipolar Disorder
1. What is it?
2. What is its stigma?
3. Is there a blood test?
4. What are its treatments?
![Page 19: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/19.jpg)
Bipolar disorder may not be curable but it is livable
![Page 20: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/20.jpg)
Psychosocial Treatments for Bipolar Disorder
Cognitive Behavioral Therapy
Family-Focused Therapy
IPSRT
![Page 21: Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56649dab5503460f94a997be/html5/thumbnails/21.jpg)
mdl.psych.northwestern.edu