Long-Term Management Strategies to Achieve Optimal Function in Patients With Bipolar Disorder
J Clin Psychiatry 2006;67(12):e17
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Predictors of poor functional outcome in patients with
bipolar disorder include psychiatric and medical comorbidity, interepisode
subsyndromal symptoms, psychosis during manic or mixed episode, and low
premorbid functioning. Cognitive dysfunction may also contribute to functional
impairment. Psychosocial intervention has shown success in improving syndromal
outcomes for people with bipolar disorder. Lithium, lamotrigine, olanzapine,
and aripiprazole have all shown substantial improvements in relapse rates
compared with placebo. Combination therapy with antipsychotics and
antidepressants has also been shown to produce improvement in symptoms in
people with bipolar disorder. However, limited evidence is available for the
effects of these treatments on cognitive outcomes. This review discusses
treatment strategies for the long-term management of bipolar disorder and
functional outcome measures associated with these treatments.
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