Complexities of Bipolar Depression With DSM Specifiers

CE / CME

Addressing the Complexities of Bipolar Depression With DSM Specifiers

Nurses: 1.00 Nursing contact hour, including 1.00 hour of pharmacotherapy credit

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: September 26, 2024

Expiration: September 25, 2025

Charles DeBattista
Charles DeBattista, DMH, MD

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Approximately what proportion of patients with bipolar disorder experiencing a mood episode (manic, hypomanic, or depressive) meet criteria for the mixed features specifier?

2.

Which statement regarding treatment of patients with bipolar and major depressive disorders is FALSE?

3.

JK is a 33-yr-old woman initially diagnosed with major depressive disorder. The diagnosis was changed to bipolar II depression 3 yr ago after she experienced a hypomanic episode. In retrospect, she likely had a hypomanic episode in her early 20s that was missed.


She has received sequential antidepressants in the past, which were initially partially effective but not effective long term. She has also received psychotherapy (primarily cognitive behavioral therapy).


Currently, the focus of clinical concern is prominent anxiety which has been very distressing. With her depression, she is experiencing distractibility, dysphoria, and racing thoughts. Her friends report she is unusually talkative and has been engaging in risky behaviors. Her BMI is 27.5 and her thyroid is normal.


Her current diagnosis is bipolar depression with mixed features. Her symptoms fall short of the criteria for anxious distress.

What is the best treatment option for her at this time?