LS-04-01
Medical comorbidities and bipolar disorder
S. Kasper. Medizinische Universität Allgera. Psychiatrie, Wien, Austria
Nearly 20% of all patients with bipolar disorder have a comorbid illness. Younger patients are more likely to have a comorbid psychiatric illness, while comorbid, physical illness is a greater problem in the elderly. The prevalence of comorbidity associated with bipolar disorder creates a unique diagnostic and treatment challenge. Illnesses such as epilepsy and cardiovascular disease are also strongly associated with bipolar disorder. This symposium will review the methods of assessing comorbid illnesses that may disguise the presence of, as well as affect the course and prognosis of, bipolar disorder. Comorbid illnesses also impact treatment; therefore, strategies for selecting appropriate treatment options will be discussed.
LS-04-02
Drug abuse and bipolar disorder
S. Stakowski. Germany
In the 1920s, Kraepelin recognized the frequent occurrence of alcoholism in bipolar disorder. The incidence of comorbid alcohol and substance abuse with bipolar disorder ranges from 46%-76% compared to only 14% in the population as a whole. Thirty-four percent of bipolar patients with a history of suicide attempts have a positive family history of drug abuse. Alcoholism appears to be more prevalent in family members of bipolar adults and children. The severity of mania episodes, but not depressive episodes, is associated with drug abuse. Substance abuse is associated with medication non-compliance, more mixed or dysphoric mania, and more hospitalizations. Correct diagnosis needs to be a priority since drugs of abuse, particularly stimulants are associated with symptoms similar to those of mania or even psychosis.
LS-04-03
Depression and bipolar disorder
H.-J. Möller. Ludwig-Maximilians-Universität Klinik für Psychiatrie, München, Germany
Bipolar depression is difficult to diagnose and challenging to treat. Sixty percent of patients are misdiagnosed an average of 3.5 times before receiving the appropriate diagnosis. Most commonly, patients are misdiagnosed as having unipolar depression, anxiety disorder, and schizophrenia. Methods of distinguishing bipolar depression from other psychiatric illnesses will be presented. Past history, phenomenology, family history, and treatment response will all be characterized as indicators of the presence of bipolar disorder. Differential diagnosis is imperative in choosing therapy. One focus will be the available treatment options, as well as the appropriate use of antidepressants.
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