Posted by SLS on September 5, 2008, at 19:59:45
In reply to Re: Bipolar Spectrum: Very long but very accurate. » SLS, posted by Bob on September 5, 2008, at 12:56:22
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> > Final Word
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> > In his introductory article, Dr Ghaemi points out that in the bipolar literature, treatment issues receive a lot more attention than diagnostic considerations. Yet, "in the practice of psychopharmacology, treatment decisions are often straightforward once diagnostic judgments are made."
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> Huh? Seems to be that this mood disorder bipolar spectrum issue might be one of the most challenging problems to solve in medecine, if not in the entire panolpy of human experience.
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> Although one has to start somewhere, that article seems to leave more lose ends and open questions then ever. Even if all the myriad diagnoatic, sub-diagnostic, and sub-category/sub-diagnostic criteria are to be worked out at some point, I feel that the treatment options are anything but straightforward in many cases. In fact, it appears that in many cases, there is no idea how to proceed. Heck, we often don't understand what to do for people who are pure severe unipolar, yet completely treatment resistant. They even mention in the article that people who are BPII and/or rapid cycling very often don't improve with the introduction of Lithium or other mood stabilizers.I understand your reaction. I think most of us are in agreement that bipolar disorders are difficult to treat, and that even the most accurate of diagnoses do not guarantee treatability.
I think the premise of the article is sound; that there are indeed different subtypes of bipolar disorder whose presentations show an interindividual consistency in the aggregation of symptom clusters and biological traits. That a piece of literature opens up the opportunity to ask more questions is not a weakness, but a strength. Also, that the accepted treatment algorithm for a bipolar subtype is "straight forward" does not indicate that it is effective. It just indicates that there is a consensus as to how to best treat a particular presentation, even if the success rate is very low.
- Scott
poster:SLS
thread:850483
URL: http://www.dr-bob.org/babble/20080903/msgs/850558.html