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Long-Term Management Strategies to Achieve Optimal Function in Patients With Bipolar Disorder

Paul E. Keck

Published: December 15, 2006

Article Abstract

Predictors of poor functional outcome in patients withbipolar disorder include psychiatric and medical comorbidity, interepisodesubsyndromal symptoms, psychosis during manic or mixed episode, and lowpremorbid functioning. Cognitive dysfunction may also contribute to functionalimpairment. Psychosocial intervention has shown success in improving syndromaloutcomes for people with bipolar disorder. Lithium, lamotrigine, olanzapine,and aripiprazole have all shown substantial improvements in relapse ratescompared with placebo. Combination therapy with antipsychotics andantidepressants has also been shown to produce improvement in symptoms inpeople with bipolar disorder. However, limited evidence is available for theeffects of these treatments on cognitive outcomes. This review discussestreatment strategies for the long-term management of bipolar disorder andfunctional outcome measures associated with these treatments.

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