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Recent research: free June edition of "Clinical Psychology: Science and Practice" focuses on bipolar disorder

The June edition of the journal "Clinical psychology: science and practice"  focused on bipolar disorder.  This is very valuable and the fact that all the articles are freely viewable in full text makes the publication even more helpful.  As Youngstrom & Kendall write in their introductory article (see below) "Knowledge about bipolar disorder is rapidly advancing. One consequence is that current evidence about the diagnostic definitions, prevalence, phenomenology, associated features and underlying processes, risk factors and predictors, and assessment or treatment strategies for bipolar disorder is often markedly different than the conventional wisdom reflected even in recent textbooks and clinical training."  Karam & Fayyad (see below for all articles mentioned, with abstracts and links) discuss diagnosis and the boundaries of the bipolar spectrum.  Merikangas & Pato review recent research on bipolar epidemiology and write "During the past decade, there has been increasing recognition of the dramatic personal and societal impact of bipolar disorder I and II (DSM-IV). The estimated disability-adjusted life years of bipolar disorder outrank all cancers and primary neurologic disorders, such as epilepsy and Alzheimer's disease, primarily because of its early onset and chronicity across the lifespan". Miller, Johnson, et al. in their article on assessment measures " ... review diagnostic tools, self-report measures to facilitate screening for bipolar diagnoses, and symptom severity measures". Hunsley, in a linked commentary, discusses assessment further.  Finally Alloy, Abramson, et al. " ... review longitudinal predictors, primarily psychosocial, of the onset, course, and expression of bipolar spectrum disorders. We organize our review along a proximal-distal continuum, discussing the most proximal (i.e., prodromes) predictors of bipolar episodes first, then recent environmental (i.e., life events) predictors of bipolar symptoms and episodes next, followed by more distal psychological (i.e., cognitive styles) predictors, and ending with the most distal temperament (i.e., Behavioral Approach System [BAS] sensitivity) predictors. We then present a theoretical model, the BAS dysregulation model, for understanding and integrating the role of these predictors of bipolar spectrum disorders".

Youngstrom, Eric, A. and Kendall, Philip, C. (2009). "Psychological Science and Bipolar Disorder." Clinical Psychology: Science and Practice 16(2): 93-97. [Free Full Text]  
Knowledge about bipolar disorder is rapidly advancing. One consequence is that current evidence about the diagnostic definitions, prevalence, phenomenology, associated features and underlying processes, risk factors and predictors, and assessment or treatment strategies for bipolar disorder is often markedly different than the conventional wisdom reflected even in recent textbooks and clinical training. This Special Issue draws together a series of reviews discussing the evidence with emphasis on the contributions of psychological science and attention to the implications for evidence-based practice. International experts from multiple disciplines provide additional commentaries that set the reviews in a global, interdisciplinary context.

Karam, E. G.  and Fayyad, J. A. (2009). "The Boundaries of Bipolarity: Comments on the Epidemiology of Bipolar Disorder." Clinical Psychology: Science and Practice 16(2): 134-139.   [Free Full Text]   
The review of epidemiological studies of bipolar disorder (Merikangas & Pato, 2009) raises a challenging question: How subtle should be the approach to bipolar disorders? Research has accumulated clearly favoring the presence of "bipolarity" beyond the classical manic-depressive psychosis. Hypomanic and manic symptoms are increasingly documented in seemingly "unipolar" patients, and this is affecting the approach to the conceptualization of this disorder, its treatment, and the search for its etiologies. Refined instruments and longitudinal studies provide a fascinating database that will intensify the discussions about the boundaries of the bipolar spectrum. Issues facing children and adolescents, adults, and persons of old age are considered.

Merikangas, Kathleen, R. and Pato, Michael. (2009). "Recent Developments in the Epidemiology of Bipolar Disorder in Adults and Children: Magnitude, Correlates, and Future Directions." Clinical Psychology: Science and Practice 16(2): 121-133.   [Free Full Text]   
During the past decade, there has been increasing recognition of the dramatic personal and societal impact of bipolar disorder I and II (DSM-IV). The estimated disability-adjusted life years of bipolar disorder outrank all cancers and primary neurologic disorders, such as epilepsy and Alzheimer's disease, primarily because of its early onset and chronicity across the lifespan (World Health Report, 2002). The results of numerous international epidemiologic surveys using contemporary diagnostic criteria have strengthened the evidence base on the magnitude, correlates, and consequences of bipolar disorder in representative samples of the general population. Epidemiologic research has also demonstrated the differences between clinical and community samples in terms of demographic factors, comorbidity, patterns of onset, severity, treatment utilization, and response. The aims of this article are (a) to summarize the magnitude of the prevalence of bipolar disorder in adults and children through a comprehensive review of DSM-IV bipolar disorder in the general population; (b) to describe the risk factors and correlates of bipolar disorder in community surveys; and (c) to describe the future directions for the field of epidemiology of bipolar disorder.

Miller, C. J. , L. Johnson, et al. (2009). "Assessment Tools for Adult Bipolar Disorder." Clinical Psychology: Science and Practice 16(2): 188-201.  [Free Full Text]   
This article reviews the current state of the literature on the assessment of bipolar disorder in adults. Research on reliable and valid measures for bipolar disorder has unfortunately lagged behind assessment research for other disorders, such as major depression. We review diagnostic tools, self-report measures to facilitate screening for bipolar diagnoses, and symptom severity measures. We briefly review other assessment domains, including measures designed to facilitate self-monitoring of symptoms. We highlight particular gaps in the field, including an absence of research on the reliable diagnosis of bipolar II and milder forms of disorder, a lack of empirical data on the best ways to integrate data from multiple domains, and a shortage of measures targeting a broader set of illness-related constructs relevant to bipolar disorder.

Hunsley, John. (2009). "Advancing the Role of Assessment in Evidence-Based Psychological Practice." Clinical Psychology: Science and Practice 16(2): 202-205.  [Free Full Text]  
Miller, Johnson, and Eisner's (2009) thorough review of the assessment literature for bipolar disorders (BD) in adults provides valuable guidance to both clinicians and researchers. This commentary highlights the range of scientifically sound instruments available and the current limitations evident in the BD assessment literature. I discuss how these limitations are also evident in the assessment research on other disorders and how improvements in assessment instruments (including those used for the purposes of diagnosis, case formulation, and treatment monitoring and evaluation) are central to the promotion and implementation of evidence-based practice in psychology.

Alloy, L. B., L. Y. Abramson, et al. (2009). "Longitudinal Predictors of Bipolar Spectrum Disorders: A Behavioral Approach System Perspective." Clinical Psychology: Science and Practice 16(2): 206-226.   [Free Full Text]   
We review longitudinal predictors, primarily psychosocial, of the onset, course, and expression of bipolar spectrum disorders. We organize our review along a proximal-distal continuum, discussing the most proximal (i.e., prodromes) predictors of bipolar episodes first, then recent environmental (i.e., life events) predictors of bipolar symptoms and episodes next, followed by more distal psychological (i.e., cognitive styles) predictors, and ending with the most distal temperament (i.e., Behavioral Approach System [BAS] sensitivity) predictors. We then present a theoretical model, the BAS dysregulation model, for understanding and integrating the role of these predictors of bipolar spectrum disorders. Finally, we consider the implications of the reviewed longitudinal predictors for future research and psychosocial treatments of bipolar disorders.

 

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