Unipolar or Bipolar Depression?

CE / CME

eCase: Identifying Bipolar Disorder in a Currently Depressed Patient

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

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

Social Workers: 1.00 ASWB ACE CE Credit

Pharmacists: 1.00 contact hour (0.1 CEUs)

Psychologists: 1.00 APA CE Credit

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit

Released: December 30, 2022

Expiration: December 29, 2023

Denise Vanacore
Denise Vanacore,

Activity

Progress
1
Course Completed
Which validated screening tools are designed to screen for bipolar disorder?
Which of the following are approved by the FDA specifically for bipolar II depression?

  1. National Alliance on Mental Illness. Mental health by the numbers. www.nami.org/mhstats. Accessed December 22, 2022.
  2. National Institute of Mental Health. Bipolar disorder: definition. www.nimh.nih.gov/health/statistics/bipolar-disorder. Accessed December 22, 2022.
  3. National Institute of Mental Health. Bipolar disorder. www.nimh.nih.gov/health/publications/bipolar-disorder. Accessed December 22, 2022.
  4. Rowland T, Marwaha S. Epidemiology and risk factors for Bipolar disorder Ther Adv Psychopharmacol. 2018;8:251-269.
  5. Özdemir O, Coşkun S, Aktan Mutlu E, et al. Family history in patients with bipolar disorder. Noro Psikiyatr Ars. 2016;53:276-279.
  6. Post R, Altshuler L, Kupka R, et al. Multigenerational positive family history of psychiatric disorders is associated with a poor prognosis in bipolar disorder. Neuropsychiatry Clin Neurosci. 2015;27:304-310.
  7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-5-TR. Arlington, VA: American Psychiatric Association; 2022.
  8. Daily MW, Saadabadi A. Mania. www.ncbi.nlm.nih.gov/books/NBK493168. Accessed December 22, 2022.
  9. McIntyre RS, Zimmerman M, Goldberg JF, et al. Differential diagnosis of major depressive disorder versus bipolar disorder: current status and best clinical practices. J Clin Psychiatry. 2019;80:ot18043ah2
  10. Nasrallah H. Misdiagnosing bipolar disorder as major depressive disorder. cdn.mdedge.com/files/s3fs-public/Document/September-2017/020_1013CP_FromTheEditor_FINAL.pdf. Accessed December 22, 2022.
  11. Singh T, Rajput M. Misdiagnosis of bipolar disorder. Psychiatry (Edgmont). 2006;3:57-63..
  12. Dagani J, Signorini G, Nielssen O, et al. Meta-analysis of the interval between the onset and management of bipolar disorder. Can J Psychiatry. 2017;62:247-258.
  13. Drancourt N, Etain B, Lajnef M, et al. Duration of untreated bipolar disorder: missed opportunities on the long road to optimal treatment. Acta Psychiatr Scand. 2013;127:136-144.
  14. Mahmoud DR, Yang A, Ciolino JD, et al. Validity of the WHIPLASHED as a tool to identify bipolar disorder in women. J Affect Disord. 2019;246:69-73.
  15. Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013;381:1672-1682. 
  16. Baldessarini RJ, Tondo L, Vázquez GH. Pharmacological treatment of adult bipolar disorder. Mol Psychiatry. 2019;24:198-217. 
  17. Goldberg JF. Complex combination pharmacotherapy for bipolar disorder: knowing when less is more or more is better. Focus (Am Psychiatr Publ). 2019;17:218-231.
  18. Vieta E, Berk M, Schulze TG, et al. Bipolar disorders. Nat Rev Dis Primers. 2018;4:18008. 
  19. Montano CB, Jackson WC, Vanacore D, et al. Practical advice for primary care clinicians on the safe and effective use of vortioxetine for patients with major depressive disorder (MDD). Neuropsychiatr Dis Treat. 2022;18:867-879.
  20. Goldberg JF. Antidepressants: the scapegoat of poor outcome bipolar disorder? Aust N Z J Psychiatry. 2012;46:302-305.
  21. Youssef NA, Aquadro E, Thomas A, et al. A primary care guide to bipolar depression treatment. J Fam Pract. 2020;69:344-352. 
  22. Citrome L. Food and Drug Administration-approved treatments for acute bipolar depression: what we have and what we need. J Clin Psychopharmacol. 2020;40:334
  23. Meyer JM. Lumateperone for major depressive episodes in bipolar I or bipolar II disorder. cdn.mdedge.com/files/s3fs-public/CP02103044.PDF. Accessed December 22, 2022.
  24. Loebel A, Cucchiaro J, Silva R, et al. Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2014;171:160.
  25. Earley WR, Burgess MV, Khan B, et al.Efficacy and safety of cariprazine in bipolar I depression: a double-blind, placebo-controlled phase 3 study. Bipolar Disord. 2020;22:372.
  26. Calabrese JR, Durgam S, Satlin A, et al. Efficacy and safety of lumateperone for major depressive episodes associated with bipolar I or bipolar II disorder: a phase 3 randomized placebo-controlled trial. Am J Psychiatry. 2021;178:1098
  27. Yatham LN, Kennedy SH, Parikh SV, et al. 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. 2018;20:97-170.
  28. Lurasidone prescribing information. Marlborough, MA: Sunovion; 2022.
  29. Hirschfeld RM, Calabrese JR, Frye MA, et al. Defining the clinical course of bipolar disorder: response, remission, relapse, recurrence, and roughening. Psychopharmacol Bull. 2007;40:7-14.