Interactive Professor

Improving Outcomes in Bipolar Depression

Overcoming Diagnostic Challenges, Targeting Remission, and Optimizing Cardiometabolic Health

Meeting Slides


Depression and Bipolar Support Alliance

The Depression and Bipolar Support Alliance (DBSA) Web site offers information, education, and support for individuals suffering from bipolar depression. Tools such as the mental health screening center helps patients track and assess their symptoms. The Web site also offers a mood calendar that helps patients document their moods and may be of use to both patient and clinician when monitoring treatment efficacy.

Mood Disorder Questionnaire

The questionnaire was developed to address a critical need for timely and accurate diagnosis of bipolar disorder. A screening score of 7 or more items across 3 criteria yields a positive screen for bipolar disorder. It has very good sensitivity and specificity.
Hirschfeld RM, et al. Am J Psychiatry. 2000;157:1873-1875.

Bipolar Depression Rating Scale

The Bipolar Depression Rating Scale is designed to measure the severity of current depressive symptoms in bipolar depression. The scale contains 20 questions for a maximum score of 60. Higher scores indicate greater severity.
Berk M, et al. Bipolar Disord. 2007;9:571-579.


Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition)

2013 version of the American Psychological Association’s diagnostic guidelines include the bipolar disorder spectrum.
American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. 2013: Arlington, VA, American Psychiatric Publishing.

VA/DoD Clinical Practice Guideline for Management of Bipolar Disorder in Adults

Guideline statements on the step-by-step process of clinical decision-making and intervention in the diagnosis and management of bipolar disorder. Contains best practice recommendations on general care and treatment, as well as specific recommendations for an older patient population.
VA/DoD Clinical Practice Guideline for Management of Bipolar Disorder in Adults. 2010: Washington, DC, Department of Veterans Affairs, Department of Defense.

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) Collaborative Update of CANMAT Guidelines for the Management of Patients With Bipolar Disorder: Update 2013

The CANMAT-ISBD guidelines include instructions for the diagnosis, treatment, and management of bipolar disorder. The 2013 update contains new evidence for pharmacological treatments of bipolar depression as well as specific recommendations for bipolar II management.
Yatham LN, et al. Bipolar Disord. 2013:15:1-44.

Suggested Readings

Treatment options for acute depression in bipolar disorder.

Bauer M, et al. Bipolar Dis. 2012;14:37-50.

Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder.

Fiedorowicz JG, et al. Am J Psychiatry. 2011;168:40-48.

Clinical differences between bipolar and unipolar depression.

Forty L, et al. Br J Psychiatry. 2008;19:388-389.

Clinical practice. Bipolar disorder—a focus on depression.

Frye MA. N Engl J Med. 2011;364:51-59.

Acute and maintenance treatments for bipolar depression.

Ketter TA. J Clin Psychiatry. 2014;75:e10.

Strategies for monitoring outcomes in patients with bipolar disorder.

Ketter TA. Prim Care Companion J Clin Psychiatry. 2010;12:10-16.

Clinical practice recommendations for bipolar disorder.

Malhi GS, et al. Acta Psychiatr Scand. 2009;119:27-46.

Metabolic syndrome in bipolar disorder: a review with a focus on bipolar depression.

McElroy SL, Keck PE. J Clin Psychiatry. 2014;75:46-61.

Medical comorbidity in bipolar disorder: implications for functional outcomes and health service utilization.

McIntyre RS, et al. Psychiatr Serv. 2006;57:1140-1144.

The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders.

Pacchiarotti I, et al. Am J Psychiatry. 2013;170:1249-1262.

The neurobiology of the switch process in bipolar disorder: a review.

Salvadore G, et al. J Clin Psychiatry. 2010;71:1488-1501.

An update on antidepressant use in bipolar depression.

Sidor MM, MacQueen GM. Curr Psychiatry Rep. 2012;14:696-704.

Relevant Resources

Reducing the Burden of Bipolar Depression

Improved Diagnostic and Management Strategies

Comprehensive Management of Bipolar Depression

New Approaches to Optimizing Patient Outcomes

A Focus on Bipolar Depression

Overcoming Diagnostic Barriers and Optimizing Long-Term Patient Outcomes

Multidisciplinary Management of Bipolar Disorder

Accelerating Diagnosis, Achieving Remission, and Encouraging Adherence

Mixed Features in Depressive Episodes

Managing Patients Across the Disease Spectrum

Agitation and Psychiatric Disease

Best Practices for Emergency Care

Clinical Issues in Bipolar Depression

Consensus and Controversies Across the Spectrum of Patient Presentations

Expert Consult Series in Multiple Sclerosis

Updates, Clinical Scenarios, and Future Directions