Depressive and bipolar disorders are medical conditions which are often first diagnosed and treated in primary care settings [1, 2]. Hence, family physicians are in a frontline position to provide optimal care for patients who suffer from these disorders. This chapter will provide succinct and practical information on the diagnosis and most effective pharmacologic and nonpharmacologic treatments of these disorders in a primary care setting. Newer therapies, such as deep brain stimulation and special populations, will also be discussed.
Epidemiology
Mood disorders , such as major depressive disorder, persistent depressive disorder (PDD; formerly dysthymic disorder), and bipolar disorders are quite common [3]. The lifetime prevalence of having any type of mood disorder is 20 %. In 2012, it was estimated that 10.4 million adults aged 18 or older in the USA had at least one major depressive episode resulting in severe impairment in the past year. This represented 4.5 % of all US adults...
References
Culpepper L. The diagnosis and treatment of bipolar disorder: decision-making in primary care. Prim Care Companion CNS Disord. 2014; 16(3): PCC.13r01609. Published online 19 June 2014.
Ferguson JM. Depression: diagnosis and management for the primary care physician. Prim Care Companion J Clin Psychiatry. 2000;2(5):173–8.
Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry. 2005;62(6):617–27.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association. 2013
Sullivan PF, Neale MC, Kendler KS. Review: twin studies show that genes and individual environmental influences contribute to the aetiology of major depression. Am J Psychiatry. 2000;157:1552.
Smoller JW, Finn CT. Family, twin, and adoption studies of bipolar disorder. Am J Med Genet C Semin Med Genet. 2003;123C:48–58.
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.
Pies RW. WHIPLASHED: a mnemonic for recognizing bipolar depression. Psychiatric Times. 2007; http://www.psychiatrictimes.com/bipolar-disorder/whiplashed-mnemonic-recognizing-bipolar-depression/page/0/1.
Luoma JB, Martin CE, Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry. 2002;159(6):909–16.
Guintivano J, et al. Identification and replication of a combined epigenetic and genetic biomarker predicting suicide and suicidal behaviors. Am J Psychiatry. 2014;171(12):1287–96.
Zisook S, Corruble E, Duan N, Iglewicz A, Karam EG, Lanuoette N, Lebowitz B, Pies R, Reynolds C, Seay K, Katherine Shear M, Simon N, Young IT. The bereavement exclusion and the DSM-5. Depress Anxiety. 2012;29:425–43.
Cameron C, Habert J, Anand L, Furtado M. Optimizing the management of depression: primary care experience. Psychiatry Res. 2014;220 Suppl 1:S45–57.
Schulz P, Arora G. Depression. Continuum (Minneap Minn). 2015;21(3 Behavioral Neurology and Neuropsychiatry):756–71.
Cleare A, Pariante CM, Young AH, Anderson IM. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol. 2015;29(5):459–525.
Serafini G, Howland RH, Rovedi F, Girardi P, Amore M. The role of ketamine in treatment-resistant depression: a systematic review. Curr Neuropharmacol. 2014;12(5):444–61.
Stahl SM. Stahl’s essential psychopharmacology: the Prescriber’s Guide. New York: Cambridge University Press; 2014.
Qureshi NA, Al-Bedah AM. Mood disorders and complementary and alternative medicine: a literature review. Neuropsychiatr Dis Treat. 2013;9:639–58.
Ketter TA, Wang PW. Handbook of diagnosis and treatment of bipolar disorder. Washington, DC: American Psychiatric Publishing; 2010.
Ketter TA, Miller S, Dell’Osso B, Calabrese JR, Frye MA, Citrome L. Balancing benefits and harms of treatments for acute bipolar depression. J Affect Disor. 2014;169:S24–33.
Vieta E, Sanchez-Moreno J. Acute and long-term treatment of mania. Dialogues Clin Neurosci. 2008;10(2):165–79.
Connolly KR, Thase ME. The clinical management of bipolar disorder: a review of evidence-based guidelines. Prim Care Companion CNS Disord. 2011; 13(4): PCC.10r01097.
Sachs GS, Nierenberg AA, Calabrese JR, Marangell LB, Wisniewski SR, Gyulai L, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356:1711–22.
Cuijpers P. Psychotherapies for adult depression: recent developments. Curr Opin Psychiatry. 2015;28(1):24–9.
Pomm HA, Pomm RM. Management of the addicted patient in primary care. New York: Springer Publishing; 2007.
Loo C, Katalinic N, Mitchell PB, Greenberg B. Physical treatments for bipolar disorder: a review of electroconvulsive therapy, stereotactic surgery and other brain stimulation techniques. J Affect Disord. 2011;132(1):1–13.
Cleary DR, Ozpinar A, Raslan AM, Ko AL. Deep brain stimulation for psychiatric disorders: where we are now. Neurosurg Focus. 2015;38(6).
Vitiello B. Developmental aspects of pediatric psychopharmacology. In: McVoy M, Findling R, editors. Clinical manual of child and adolescent psychopharmacology. 2nd ed. 2013. p. 4–6.
Kilbourne AM, Post EP, Nossek A. Improving medical and psychiatric outcomes among individuals with bipolar disorder: a randomized controlled trial. Psychiatr Serv. 2008;59(7):760–8.
Epstein RA, Moore KM, Bobo WV. Treatment of nonpsychotic major depression during pregnancy: patient safety and challenges. Drug Healthc Patient Saf. 2014;6:109–29.
Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol. 2015;30(1):4–20.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this entry
Cite this entry
Schwartz, E.R., Allespach, H.H. (2015). Depressive and Bipolar Disorders. In: Paulman, P., Taylor, R. (eds) Family Medicine. Springer, Cham. https://doi.org/10.1007/978-1-4939-0779-3_33-1
Download citation
DOI: https://doi.org/10.1007/978-1-4939-0779-3_33-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-1-4939-0779-3
eBook Packages: Springer Reference MedicineReference Module Medicine
Publish with us
Chapter history
-
Latest
Mood Disorders- Published:
- 17 June 2020
DOI: https://doi.org/10.1007/978-1-4939-0779-3_33-3
-
Depressive and Bipolar Disorders
- Published:
- 07 January 2016
DOI: https://doi.org/10.1007/978-1-4939-0779-3_33-2
-
Original
Depressive and Bipolar Disorders- Published:
- 11 September 2015
DOI: https://doi.org/10.1007/978-1-4939-0779-3_33-1