Assessment and treatment of sleep problems in bipolar disorder—A guide for psychologists and clinically focused review

2020 ◽  
Vol 27 (3) ◽  
pp. 364-377 ◽  
Author(s):  
Emma Morton ◽  
Greg Murray
Keyword(s):  
Bipolar Disorder ◽  
Sleep Problems ◽  
Assessment And Treatment

scholarly journals Repetitive transcranial magnetic stimulation in the treatment of bipolar disorder

2020 ◽  
Vol 10 ◽  
pp. 204512532097379
Author(s):  
Danielle Hett ◽  
Steven Marwaha
Keyword(s):  
Bipolar Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Magnetic Stimulation ◽  
Sleep Problems ◽  
Bipolar Depression ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Total N ◽  
Depressive Episodes

Bipolar disorder (BD) is a debilitating mood disorder marked by manic, hypomanic and/or mixed or depressive episodes. It affects approximately 1–2% of the population and is linked to high rates of suicide, functional impairment and poorer quality of life. Presently, treatment options for BD are limited. There is a strong evidence base for pharmacological (e.g., lithium) and psychological (e.g., psychoeducation) treatments; however, both of these pose challenges for treatment outcomes (e.g., non-response, side-effects, limited access). Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, is a recommended treatment for unipolar depression, but it is unclear whether rTMS is an effective, safe and well tolerated treatment in people with BD. This article reviews the extant literature on the use of rTMS to treat BD across different mood states. We found 34 studies in total ( N = 611 patients), with most assessing bipolar depression ( n = 26), versus bipolar mania ( n = 5), mixed state bipolar ( n = 2) or those not in a current affective episode ( n = 1). Across all studies, there appears to be a detectable signal of efficacy for rTMS treatment, as most studies report that rTMS treatment reduced bipolar symptoms. Importantly, within the randomised controlled trial (RCT) study designs, most reported that rTMS was not superior to sham in the treatment of bipolar depression. However, these RCTs are based on small samples ( NBD ⩽ 52). Reported side effects of rTMS in BD include headache, dizziness and sleep problems. Ten studies ( N = 14 patients) reported cases of affective switching; however, no clear pattern of potential risk factors for affective switching emerged. Future adequately powered, sham-controlled trials are needed to establish the ideal rTMS treatment parameters to help better determine the efficacy of rTMS for the treatment of BD.

Inactograms and objective sleep measures as means to capture subjective sleep problems in patients with a bipolar disorder

2020 ◽  
Vol 22 (7) ◽  
pp. 722-730
Author(s):  
Paola Lavin‐Gonzalez ◽  
Clément Bourguignon ◽  
Olivia Crescenzi ◽  
Serge Beaulieu ◽  
Kai‐Florian Storch ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Sleep Problems ◽  
Subjective Sleep

Sleep-Related Functioning in Euthymic Patients With Bipolar Disorder, Patients With Insomnia, and Subjects Without Sleep Problems

2005 ◽  
Vol 162 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Allison G. Harvey ◽  
D. Anne Schmidt ◽  
Antonina Scarnà ◽  
Christina Neitzert Semler ◽  
Guy M. Goodwin
Keyword(s):  
Bipolar Disorder ◽  
Sleep Problems

Sleep Disorders and Depression

2014 ◽  
Author(s):  
Colleen E. Carney ◽  
Taryn G. Moss
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Clinical Management ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Clinical Care ◽  
Major Depressive ◽  
Bidirectional Relationship ◽  
Assessment And Treatment ◽  
Almost All

Major depressive disorder (MDD) commonly occurs with several sleep disorders, including hypersomnia, breathing or limb-related sleep disturbances, and most notably chronic insomnia. A bidirectional relationship exists between sleep and mood problems, and both issues often warrant timely clinical management. However, there are several assessment- and treatment-related complexities that complicate the clinical management of such patients. For example, there are several overlapping symptoms for MDD and both insomnia and hypersomnia, and the two sleep conditions are both listed as possible symptoms in the diagnostic criteria for MDD. This has led to a well-documented problem of underrecognizing and undertreating these significant disorders in the context of MDD. Moreover, certain effective depression treatments can actually worsen the coexisting sleep disorder. Understanding and treating both disorders (i.e., MDD and the co-occurring sleep disorder) is imperative for effective clinical care. Almost all (i.e., up to 90%) of those with depression report sleep problems. This chapter provides an overview of the etiologic, assessment, and treatment issues inherent in this very large, highly prevalent group.

scholarly journals Efficacy of Internet Delivered Cognitive Behaviour Therapy for Anxiety and Depression in People with Bipolar Disorder

2020 ◽  
Author(s):  
Olav Nielssen ◽  
Lauren Staples ◽  
Eyal Karin ◽  
Rony Kayrouz ◽  
Blake Dear ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Behaviour Therapy ◽  
Routine Care ◽  
Anxiety And Depression ◽  
Behaviour Therapy ◽  
Research Reporting ◽  
Cognitive Behaviour ◽  
Assessment And Treatment ◽  
Patient Health ◽  
Psychiatric Conditions

Abstract BackgroundMindSpot is a national digital mental health service providing free assessment and treatment for anxiety and depression. Mindspot services have been accessed by people with a broad range of psychiatric conditions, including people who report a diagnosis of bipolar disorder (BD). There is comparatively little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of BD (BDd), including as part of routine care. MethodDemographic characteristics, baseline scores and treatment outcomes were examined for patients who reported taking Lithium and had entries in their clinic records confirming the diagnosis of BD. Results were compared to the clinic benchmarks. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety as measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), respectively. ResultsA total of 21,745 people completed a MindSpot assessment between January 2013 and December 2019 and enrolled in a MindSpot treatment course. Of these, 124 reported that they were currently taking Lithium, of whom 83 had entries in their clinic records confirming a diagnosis of BD. Mean age of patients with confirmed BD was 43.8 years, compared to the clinic mean of 39.8 years. Their baseline symptom scores were higher than the benchmark. However, reductions in symptoms on the K-10, PHQ-9, and GAD-7 were large (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with BD, and the outcomes were comparable to clinic benchmarks. Results suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with BDd.

scholarly journals Bipolar Disorder in Children

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Kimberly Renk ◽  
Rachel White ◽  
Brea-Anne Lauer ◽  
Meagan McSwiggan ◽  
Jayme Puff ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Preschool Children ◽  
Health Service ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Service Providers ◽  
Health Service Providers ◽  
Assessment And Treatment ◽  
History Of ◽  
Assessment Strategies

Although bipolar disorder historically was thought to only occur rarely in children and adolescents, there has been a significant increase in children and adolescents who are receiving this diagnosis more recently (Carlson, 2005). Nonetheless, the applicability of the current bipolar disorder diagnostic criteria for children, particularly preschool children, remains unclear, even though much work has been focused on this area. As a result, more work needs to be done to further the understanding of bipolar symptoms in children. It is hoped that this paper can assist psychologists and other health service providers in gleaning a snapshot of the literature in this area so that they can gain an understanding of the diagnostic criteria and other behaviors that may be relevant and be informed about potential approaches for assessment and treatment with children who meet bipolar disorder criteria. First, the history of bipolar symptoms and current diagnostic criteria will be discussed. Next, assessment strategies that may prove helpful for identifying bipolar disorder will be discussed. Then, treatments that may have relevance to children and their families will be discussed. Finally, conclusions regarding work with children who may have a bipolar disorder diagnosis will be offered.

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