According to the DSM-5 book to get a diagnosis of bipolar I disorder individuals must have all of the diagnostic features.. The onset age is said to be 18 years old when diagnosing bipolar I disorder. Individuals that re separated, divorced or widowed individuals also have a higher rate of bipolar disorder. Family history is also one of the strongest and consistent risk factors. Individuals with adult relatives that have bipolar disorder have a higher increase as well. (American Psychiatric Association. 2013) Treatment options include medications, day treatment programs and hospitalization if individuals are feeling suicidal.
“A developmental approach to dimensional expression of psychopathology in childhood and adolescent offspring of parents with bipolar disorder” is an article that examines the functioning and symptoms of the development of bipolar disorder in child and adolescent offspring of parents with bipolar disorder. This was considered the first study to explore psychopathology, functionality and symptom dimensions. The study consisted of 90 offspring from 54 families with at one parent with bipolar disorder. In order for the parents to participate in the study they had to meet the criteria for bipolar I disorder. All of the diagnostic assessments given were performed by child and adolescent psychiatrists. (Moron-Nozaleda, Diaz-Caneja, Rodriguez-Toscano, Arango, Castro-Fornieles & Moreno, 2017) The Children’s Global Assessment scale was used to assess the psychosocial functioning. The Premorbid Adjustment Scale was used in the study to assess social and scholastic ability during childhood and adolescence.
In the findings of this study, they found that there was a higher prevalence in anxiety and disruptive behavior disorders. Rates were also higher in depression and bipolar disorder. There were some psychosocial risk factors listed throughout the study, some included effects on the development of psychopathology in genetically at risk youth. With given effects, there can be an impact of family dysfunction, social risk, and trauma. Many limitations were listed throughout the study as well, the symptom dimensions weren’t able to be tracked of a cross-sectional assessment was used. Another limitation of this study included was how the participants were recruited, they weren’t all recruited in the same wat so the section could have been bias. One of the last limitations included in this study was the size of the samples, they could have limited the ability to get the significant differences in the developmental elements. Early subsyndromal psychopathology may design prevention and early intervention programs for the high risk population. (Moron-Nozaleda, Diaz-Caneja, Rodriguez-Toscano, Arango, Castro-Fornieles & Moreno, 2017)
According to Zimmerman. (2019), research has shown that bipolar disorder and borderline personality disorder are both serious public health issues. Both disorders experience some of the same similarities which include impaired functioning, high rate of psychiatric services and substance abuse disorders and suicidality. Research shows that bipolar disorder and borderline personality can be easy to get confused when diagnosing which can lead to an overlap in diagnostic frequency. Researchers reported that individuals with bipolar disorder with borderline personality disorder had more mood episodes an earlier onset of bipolar disorder and a higher rate of suicidality. Researchers also found individuals to have a higher prevalence in substance abuse as well. The methods to improve diagnostic assessment and services project (MIDAS) project was done by Zimmerman where he was examining clinical experiences with individuals with bipolar and borderline personality disorder because both disorders had a higher risk for suicide and marked impairment. (Zimmerman, 2019).
He compared the family history and clinical characteristics of groups of individuals. The MIDAS showed some risk factors, which including that borderpolar individuals had the most psychopathology in their first-degree relatives. Borderpolar has a higher risk of episodes of depression, and more anger than bipolar disorder. (Zimmerman 2019) The results of the MIDAS project report that individuals with both bipolar disorder and borderline personality disorder are more ill than individuals with just one of the disorders. Zimmerman states that throughout the past decade there has been an effort to improve the acknowledgment of bipolar disorder. There has been a lot of different screening assessments and scales that have been developed for screening bipolar disorder. In the study it was reported that no research has explored the potential treatments for patients with both diagnoses. Individuals with both of these diagnoses represent groups of individuals experiencing severe psychosocial morbidity suicidal and mostly likely unemployed. Zimmerman has suggested that there should be more efforts when identifying better effective ways when treating individuals with these diagnoses. (Zimmerman 2019)
In the article “Weight changes associated with antiepileptic mood stabilizers in the treatment of bipolar disorder” examines the management of body weight changes during the use of stabilizers in bipolar disorder. The researchers have performed a systematic literature search of Embase, which they only collected information regarding prevention, treatment and monitoring of weight changes in nonlithium stabilizers. (Grootens, Hartong, Doornhos, Bakker, Hadjuthy & Ruhe 2018) Four psychiatrists, a pharmacist, a physician assitant and two others, they were all working with individuals with bipolar disorder of all ages. Some mood stabilizers showed an association with weight gain and some showed low risk of weight gain. In the study, researchers suggested to have a more “proactive” approach when finding the choice of mood stabilizers in the treatment of bipolar disorder. They also suggest that weight monitoring should be considered earlier. (Grootens, Hartong, Doornhos, Bakker, Hadjuthy & Ruhe 2018)
There were also some limitations throughout the study, one included the systematic research on weight monitoring straegies were not present. The evidence shown in the study for strategies to prevent weight change was very limited as well. Weight gain can have a major impact on individual’s lives so it is vital to find better effective ways to help individuals keep their weight under control. Throughout all of these studies each had different purposes. Each study has shown how bipolar disorder effects individuals daily whether it be physically or psychologically. (Grootens, Hartong, Doornhos, Bakker, Hadjuthy & Ruhe 2018)
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA
- Grootens, K. P., Meijer, A., Hartong, E. G., Doornbos, B., Bakker, P. R., Al Hadithy, A., Ruhe, H. G. (2018). Weight changes associated with antiepileptic mood stabilizers in the treatment of bipolar disorder. European Journal of Clinical Pharmacology, 74(11), 1485–1489.
- Morón-Nozaleda, M., Díaz-Caneja, C., Rodríguez-Toscano, E., Arango, C., Castro-Fornieles, J., de la Serna, E., … Moreno, D. (2017). A developmental approach to dimensional expression of psychopathology in child and adolescent offspring of parents with bipolar disorder. European Child & Adolescent Psychiatry, 26(10), 1165–1175.
- Zimmerman, M. (2019). Borderpolar: Patients with Borderline Personality Disorder and Bipolar Disorder. Psychiatric Times, 36(12), 17–18.