Bipolar Disorders,
Journal Year:
2018,
Volume and Issue:
20(2), P. 97 - 170
Published: March 1, 2018
The
Canadian
Network
for
Mood
and
Anxiety
Treatments
(CANMAT)
previously
published
treatment
guidelines
bipolar
disorder
in
2005,
along
with
international
commentaries
subsequent
updates
2007,
2009,
2013.
last
two
were
collaboration
the
International
Society
Bipolar
Disorders
(ISBD).
These
2018
CANMAT
ISBD
Treatment
Guidelines
represent
significant
advances
field
since
full
edition
was
including
to
diagnosis
management
as
well
new
research
into
pharmacological
psychological
treatments.
have
been
translated
clear
easy
use
recommendations
first,
second,
third-
line
treatments,
consideration
given
levels
of
evidence
efficacy,
clinical
support
based
on
experience,
consensus
ratings
safety,
tolerability,
treatment-emergent
switch
risk.
New
these
guidelines,
hierarchical
rankings
created
first
second-
treatments
recommended
acute
mania,
depression,
maintenance
I
disorder.
Created
by
considering
impact
each
across
all
phases
illness,
this
hierarchy
will
further
assist
clinicians
making
evidence-based
decisions.
Lithium,
quetiapine,
divalproex,
asenapine,
aripiprazole,
paliperidone,
risperidone,
cariprazine
alone
or
combination
are
first-line
mania.
First-line
options
depression
include
lurasidone
plus
lithium
lithium,
lamotrigine,
lurasidone,
adjunctive
lamotrigine.
While
medications
that
shown
be
effective
phase
should
generally
continued
disorder,
there
some
exceptions
(such
antidepressants);
available
data
suggest
aripiprazole
monotherapy
considered
those
initiating
switching
during
phase.
In
addition
addressing
issues
also
provide
an
overview
of,
for,
II
advice
specific
populations,
such
women
at
various
stages
reproductive
cycle,
children
adolescents,
older
adults.
There
discussions
psychiatric
medical
comorbidities
substance
use,
anxiety,
metabolic
disorders.
Finally,
related
safety
monitoring
is
provided.
groups
hope
become
a
valuable
tool
practitioners
globe.
BMC Medicine,
Journal Year:
2017,
Volume and Issue:
15(1)
Published: Jan. 28, 2017
The
possible
therapeutic
impact
of
dietary
changes
on
existing
mental
illness
is
largely
unknown.
Using
a
randomised
controlled
trial
design,
we
aimed
to
investigate
the
efficacy
improvement
program
for
treatment
major
depressive
episodes.
'SMILES'
was
12-week,
parallel-group,
single
blind,
an
adjunctive
intervention
in
moderate
severe
depression.
consisted
seven
individual
nutritional
consulting
sessions
delivered
by
clinical
dietician.
control
condition
comprised
social
support
protocol
same
visit
schedule
and
length.
Depression
symptomatology
primary
endpoint,
assessed
using
Montgomery–Åsberg
Rating
Scale
(MADRS)
at
12
weeks.
Secondary
outcomes
included
remission
change
symptoms,
mood
anxiety.
Analyses
utilised
likelihood-based
mixed-effects
model
repeated
measures
(MMRM)
approach.
robustness
estimates
investigated
through
sensitivity
analyses.
We
166
individuals
eligibility,
whom
67
were
enrolled
(diet
intervention,
n
=
33;
control,
34).
Of
these,
55
utilising
some
form
therapy:
21
psychotherapy
pharmacotherapy
combined;
9
exclusively
psychotherapy;
25
only
pharmacotherapy.
There
31
diet
group
who
had
complete
data
demonstrated
significantly
greater
between
baseline
weeks
MADRS
than
group,
t(60.7)
4.38,
p
<
0.001,
Cohen's
d
–1.16.
Remission,
defined
as
score
<10,
achieved
32.3%
(n
10)
8.0%
2)
groups,
respectively
(χ
2
(1)
4.84,
0.028);
number
needed
treat
(NNT)
based
scores
4.1
(95%
CI
NNT
2.3–27.8).
A
analysis,
testing
departures
from
missing
random
(MAR)
assumption
dropouts,
indicated
that
robust
violations
MAR
assumptions.
These
results
indicate
may
provide
efficacious
accessible
strategy
management
this
highly
prevalent
disorder,
benefits
which
could
extend
common
co-morbidities.
Australia
New
Zealand
Clinical
Trials
Register
(ANZCTR):
ACTRN12612000251820
.
Registered
29
February
2012.
World Psychiatry,
Journal Year:
2020,
Volume and Issue:
19(3), P. 360 - 380
Published: Sept. 15, 2020
There
is
increasing
academic
and
clinical
interest
in
how
“lifestyle
factors”
traditionally
associated
with
physical
health
may
also
relate
to
mental
psychological
well‐being.
In
response,
international
national
bodies
are
producing
guidelines
address
behaviors
the
prevention
treatment
of
illness.
However,
current
evidence
for
causal
role
lifestyle
factors
onset
prognosis
disorders
unclear.
We
performed
a
systematic
meta‐review
top‐tier
examining
activity,
sleep,
dietary
patterns
tobacco
smoking
impact
on
risk
outcomes
across
range
disorders.
Results
from
29
meta‐analyses
prospective/cohort
studies,
12
Mendelian
randomization
two
meta‐reviews,
randomized
controlled
trials
were
synthesized
generate
overviews
targeting
each
specific
depression,
anxiety
stress‐related
disorders,
schizophrenia,
bipolar
disorder,
attention‐deficit/hyperactivity
disorder.
Standout
findings
include:
a)
convergent
indicating
use
activity
primary
spectrum
disorders;
b)
emerging
implicating
as
factor
both
common
severe
illness;
c)
need
clearly
establish
relations
between
illness,
diet
should
be
best
addressed
within
care;
d)
poor
sleep
although
further
research
required
understand
complex,
bidirectional
benefits
non‐pharmacological
sleep‐focused
interventions.
The
potentially
shared
neurobiological
pathways
multiple
discussed,
along
directions
future
research,
recommendations
implementation
these
at
public
service
levels.
Australian & New Zealand Journal of Psychiatry,
Journal Year:
2016,
Volume and Issue:
50(5), P. 410 - 472
Published: April 22, 2016
Objectives:
This
guideline
provides
recommendations
for
the
clinical
management
of
schizophrenia
and
related
disorders
health
professionals
working
in
Australia
New
Zealand.
It
aims
to
encourage
all
clinicians
adopt
best
practice
principles.
The
represent
consensus
a
group
Australian
Zealand
experts
disorders.
includes
ultra-high
risk
syndromes,
first-episode
psychoses
prolonged
psychoses,
including
associated
with
substance
use.
takes
holistic
approach,
addressing
aspects
care
people
disorders,
not
only
correct
diagnosis
symptom
relief
but
also
optimal
recovery
social
function.
Methods:
writing
planned
scope
individual
members
drafted
sections
according
their
area
interest
expertise,
reference
existing
systematic
reviews
informal
literature
undertaken
this
guideline.
In
addition,
specific
areas
contributed
relevant
sections.
All
reviewed
entire
document.
considered
international
guidelines.
Evidence-based
were
formulated
when
judged
that
there
was
sufficient
evidence
on
topic.
Where
weak
or
lacking,
consensus-based
formulated.
Consensus-based
are
based
field
informed
by
agreement
as
group,
collective
research
knowledge
experience.
Key
considerations
selected
group.
To
wide
community
participation,
Royal
College
Psychiatrists
invited
review
its
committees
members,
an
expert
advisory
committee
key
stakeholders
professional
bodies
special
groups.
Results:
reflects
increasing
emphasis
early
intervention,
physical
health,
psychosocial
treatments,
cultural
improving
vocational
outcomes.
uses
staging
model
framework
regarding
assessment,
treatment
ongoing
care.
refers
readers
published
guidelines
statements
directly
practice.
Conclusions:
improve
these
living
advocates
respectful,
collaborative
approach;
evidence-based
treatment;
consideration
needs
those
adverse
circumstances
facing
additional
challenges.
International Journal of Bipolar Disorders,
Journal Year:
2016,
Volume and Issue:
4(1)
Published: Nov. 21, 2016
Despite
its
virtually
universal
acceptance
as
the
gold
standard
in
treating
bipolar
disorder,
prescription
rates
for
lithium
have
been
decreasing
recently.
Although
this
observation
is
multifactorial,
one
obvious
potential
contributor
side
effect
and
toxicity
burden
associated
with
lithium.
Additionally,
concerns
assuredly
play
some
role
nonadherence.
This
paper
summarizes
knowledge
base
on
effects
suggests
optimal
management
of
these
problems.
Thirst
excessive
urination,
nausea
diarrhea
tremor
are
rather
common
that
typically
no
more
than
annoying
even
though
they
prevalent.
A
simple
set
strategies
involve
timing
dose,
minimizing
levels
within
therapeutic
range
and,
situations,
antidotes
will
minimize
patients.
In
contrast,
weight
gain
cognitive
impairment
from
tend
to
be
distressing
patients,
difficult
manage
likely
Lithium
has
adverse
kidneys,
thyroid
gland
parathyroid
glands,
necessitating
monitoring
organ
functions
through
periodic
blood
tests.
most
cases,
lithium-associated
renal
relatively
mild.
small
but
measurable
percentage
lithium-treated
patients
show
progressive
impairment.
Infrequently,
need
discontinued
because
insufficiency.
Lithium-induced
hypothyroidism
easily
diagnosed
treated.
Hyperparathyroidism
a
recently
recognized
phenomenon.
Australian & New Zealand Journal of Psychiatry,
Journal Year:
2020,
Volume and Issue:
55(1), P. 7 - 117
Published: Dec. 22, 2020
Objectives:
To
provide
advice
and
guidance
regarding
the
management
of
mood
disorders,
derived
from
scientific
evidence
supplemented
by
expert
clinical
consensus
to
formulate
s
that
maximise
utility.
Methods:
Articles
information
sourced
search
engines
including
PubMed,
EMBASE,
MEDLINE,
PsycINFO
Google
Scholar
were
literature
known
disorders
committee
(e.g.
books,
book
chapters
government
reports)
published
depression
bipolar
disorder
guidelines.
Relevant
was
appraised
discussed
in
detail
members
committee,
with
a
view
formulating
developing
consensus-based
recommendations
guidance.
The
guidelines
subjected
rigorous
consultation
external
review
involving:
advisors,
key
stakeholders,
professional
bodies
specialist
groups
interest
disorders.
Results:
Royal
Australian
New
Zealand
College
Psychiatrists
practice
2020
(MDcpg
)
up-to-date
is
informed
experience.
guideline
intended
for
use
psychiatrists,
psychologists,
primary
care
physicians
others
an
mental
health
care.
Conclusion:
MDcpg
builds
on
previous
2015
maintains
its
joint
focus
both
depressive
It
provides
within
evidence-based
framework,
consensus.
Mood
committee:
Gin
S
Malhi
(Chair),
Erica
Bell,
Darryl
Bassett,
Philip
Boyce,
Richard
Bryant,
Hazell,
Malcolm
Hopwood,
Bill
Lyndon,
Roger
Mulder,
Porter,
Ajeet
B
Singh
Greg
Murray.
Depression and Anxiety,
Journal Year:
2019,
Volume and Issue:
37(2), P. 134 - 145
Published: Oct. 22, 2019
Varying
conceptualizations
of
treatment-resistant
depression
(TRD)
have
made
translating
research
findings
or
systematic
reviews
into
clinical
practice
guidelines
challenging
and
inconsistent.We
conducted
a
review
for
the
Centers
Medicare
&
Medicaid
Services
Agency
Healthcare
Research
Quality
to
clarify
how
experts
investigators
defined
TRD
systematically
well
this
definition
comports
with
definitions
in
trials
through
July
5,
2019.We
found
that
no
consensus
existed
TRD.
The
most
common
major
depressive
disorder
required
minimum
two
prior
treatment
failures
confirmation
adequate
dose
duration.
bipolar
one
failure.
No
clear
emerged
on
defining
adequacy
either
Our
only
17%
intervention
studies
enrolled
samples
meeting
frequently
specified
criteria
Depressive
outcomes
global
impressions
were
commonly
measured;
functional
impairment
quality-of-life
tools
rarely
used.Two
key
steps
are
critical
advancing
research:
(a)
Developing
addresses
best
specify
number
duration;
(b)
identifying
core
package
outcome
measures
can
be
applied
standardized
manner.
recommendations
about
stronger
approaches
designing
conducting
will
foster
better
evidence
translate
clearer
treating
patients
serious
condition.
World Psychiatry,
Journal Year:
2020,
Volume and Issue:
19(3), P. 269 - 293
Published: Sept. 15, 2020
Depression
is
widely
acknowledged
to
be
a
heterogeneous
entity,
and
the
need
further
characterize
individual
patient
who
has
received
this
diagnosis
in
order
personalize
management
plan
been
repeatedly
emphasized.
However,
research
evidence
that
should
guide
personalization
at
present
fragmentary,
selection
of
treatment
usually
based
on
clinician's
and/or
patient's
preference
safety
issues,
trial‐and‐error
fashion,
paying
little
attention
particular
features
specific
case.
This
may
one
reasons
why
majority
patients
with
depression
do
not
achieve
remission
first
they
receive.
The
predominant
pessimism
about
actual
feasibility
routine
clinical
practice
recently
tempered
by
some
secondary
analyses
databases
from
trials,
using
approaches
such
as
data
meta‐analysis
machine
learning,
which
indicate
variables
indeed
contribute
identification
are
likely
respond
differently
various
antidepressant
drugs
or
medication
vs.
psychotherapies.
develop
decision
support
tools
guiding
reaffirmed,
point
made
these
developed
through
large
observational
studies
comprehensive
battery
self‐report
measures.
paper
aims
describe
systematically
salient
domains
considered
effort
treatment.
For
each
domain,
available
summarized,
relevant
assessment
instruments
reviewed,
special
their
suitability
for
use
practice,
also
view
possible
inclusion
above‐mentioned
main
unmet
needs
address
area
Where
allows
providing
clinician
advice
can
already
used
today
make
more
personalized,
highlighted.
Indeed,
sections
paper,
those
neurocognition
physical
comorbidities,
modern
becoming
increasingly
complex,
several
components
other
than
simply
choice
an
psychotherapy,
reliably
personalized.
