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Case 18 - “I Don’t Feel Right”

Bipolar Disorder

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Bipolar disorder is a condition that is commonly encountered in the older adult population. Estimates are that up to 4.5% of adults in the US are affected by bipolar disorder. The estimates for older adults are between 0.5 and 1%. Starting a mood stabilizer or second-generation antipsychotic is a good first choice for those who are depressed with a known personal history of bipolar disorder and who are not already on one. It is important for healthcare providers in long-term care settings to recognize early signs of psychiatric destabilization in those with bipolar disorder. Signs of destabilization in older adults can be decreased need for sleep, increased irritability, a general increase in activity, or even the development of psychosis (delusions or hallucinations).

Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 88 - 93
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Desai, A., & Grossberg, G. (2017). Psychiatric Consultation in Long-Term Care (A Guide for Healthcare Professionals). (Cambridge University Press.) p. 125.CrossRefGoogle Scholar

Further Reading

Chakrabarti, S., & Singh, N. (2022). Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World Journal of Psychiatry, 12 (9), 12041232. https://doi.org/10.5498/wjp.v12.i9.1204CrossRefGoogle ScholarPubMed
Harrison, P. J., Cipriani, A., Harmer, C. J., Nobre, A. C., Saunders, K., Goodwin, G. M., & Geddes, J. R. (2016). Innovative approaches to bipolar disorder and its treatment. Annals of the New York Academy of Sciences, 1366 (1), 7689. https://doi.org/10.1111/nyas.13048CrossRefGoogle ScholarPubMed
Huang, H., Nissen, N., Lim, C. T., Gören, J. L., Spottswood, M., & Huang, H. (2021). Treating bipolar disorder in primary care: Diagnosis, pharmacology, and management. International Journal of General Medicine, 15, 82998314. https://doi.org/10.2147/IJGM.S386875CrossRefGoogle Scholar
McIntyre, R. S., Alda, M., Baldessarini, R. J., Bauer, M., Berk, M., Correll, C. U., Fagiolini, A., Fountoulakis, K., Frye, M. A., Grunze, H., Kessing, L. V., Miklowitz, D. J., Parker, G., Post, R. M., Swann, A. C., Suppes, T., Vieta, E., Young, A., & Maj, M. (2022). The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management. World Psychiatry, 21 (3), 364387. https://doi.org/10.1002/wps.20997CrossRefGoogle ScholarPubMed
Nolen, W. A., Licht, R. W., Young, A. H., Malhi, G. S., Tohen, M., Vieta, E., Kupka, R. W., Zarate, C., Nielsen, R. E., Baldessarini, R. J., & Severus, E. (2019). What is the optimal serum level for lithium in the maintenance treatment of bipolar disorder? A systematic review and recommendations from the ISBD/IGSLI Task Force on treatment with lithium. Bipolar Disorders, 21 (5), 394409. https://doi.org/10.1111/bdi.12805CrossRefGoogle ScholarPubMed
Novick, D. M., & Swartz, H. A. (2019). Evidence-based psychotherapies for bipolar disorder. Focus: Journal of Life-Long Learning in Psychiatry, 17 (3), 238248. https://doi.org/10.1176/appi.focus.20190004CrossRefGoogle ScholarPubMed
Poon, S. H., Sim, K., & Baldessarini, R. J. (2015). Pharmacological approaches for treatment-resistant bipolar disorder. Current Neuropharmacology, 13 (5), 592604. https://doi.org/10.2174/1570159X13666150630171954CrossRefGoogle Scholar
Rhee, T. G., Olfson, M., Nierenberg, A. A., & Wilkinson, S. T. (2020). 20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings. The American Journal of Psychiatry, 177 (8), 706. https://doi.org/10.1176/appi.ajp.2020.19091000CrossRefGoogle ScholarPubMed
Sajatovic, M., Strejilevich, S. A., Gildengers, A. G., Dols, A., Al Jurdi, R. K., Forester, B. P., Kessing, L. V., Beyer, J., Manes, F., Rej, S., Rosa, A. R., Schouws, S. N., Tsai, Y., Young, R. C., & Shulman, K. I. (2015). A report on older-age bipolar disorder from the International Society for Bipolar Disorders Task Force. Bipolar Disorders, 17 (7), 689. https://doi.org/10.1111/bdi.12331CrossRefGoogle ScholarPubMed
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., Alda, M., MacQueen, G., Milev, R. V., Ravindran, A., O’Donovan, C., McIntosh, D., Lam, R. W., Vazquez, G., Kapczinski, F., McIntyre, R. S., Kozicky, J., Kanba, S., Lafer, B., Suppes, T., Calabrese, J. R., Vieta, E., Malhi, G., Post, R. M., & Berk, M. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders, 20 (2), 97170. doi:10.1111/bdi.12609CrossRefGoogle Scholar

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  • “I Don’t Feel Right”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.019
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • “I Don’t Feel Right”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.019
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “I Don’t Feel Right”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.019
Available formats
×