Bipolar II disorder: arguments for and against a distinct diagnostic entity

Vieta, Eduard; Suppes, Trisha

doi:10.1111/j.1399-5618.2007.00561.x

Cited by 178 publications

(121 citation statements)

References 147 publications

(160 reference statements)

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“…For some patients, hypomania causes no to minimal functional impairment and may even be associated with brief periods of above‐normal functioning. However, prolonged, relatively severe, or mixed or irritable hypomania may be impairing 423. Treatment should include discontinuing agents that can worsen or prolong symptoms, including antidepressants and stimulants, and initiating appropriate pharmacotherapy.…”

Section: Bipolar II Disordermentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Bipolar II Disordermentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…Findings on neurocognitive differences between the two subtypes can be used as markers in research for underlying neurobiological distinguishers using neuroimaging techniques. Neuroimaging and genetics might be useful in validating BD II diagnostic subtype (Vieta & Suppes, 2008). Some genetic studies have suggested that BD II and BD I ' breed true ' in families ; therefore, in further studies it would be interesting to correlate clinical and neuropsychological data with genetic data in BD II patients.…”

Section: Future Directionsmentioning

confidence: 99%

“…Many clinicians still consider BD II as a mild form of classical BD, although the data indicate that it may be associated with high morbidity and mortality, including higher episode frequency, co-morbidity, suicidal behaviour and rapid cycling as compared with BD I (Vieta et al 1997(Vieta et al , 1999. Misdiagnosing BD II may also affect therapeutic decisions and therefore the course and prognosis of bipolar patients (Vieta & Suppes, 2008). An early age at onset of BD II has been associated with a higher degree of severity, a poorer treatment response and a worse prognosis (Engstrom et al 2003).…”

Section: Introductionmentioning

confidence: 99%

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Are bipolar II patients cognitively impaired? A systematic review

et al. 2011

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Background. There is evidence that bipolar disorder (BD) is associated with significant neurocognitive deficits and this occurs in individuals with BD type I (BD I) and with BD type II (BD II). Only a few studies have focused on cognitive impairment in BD II. The aim of this study was to describe the pattern of cognitive impairment in patients with BD II, in order to identify specific cognitive deficits that distinguish BD II from BD I patients as well as from healthy subjects.Method. We performed a systematic review of the literature of neuropsychological studies of BD II published between 1980 and July 2009. Fourteen articles fulfilled the inclusion criteria and were included in this review.Results. Main cognitive deficits found in BD II include working memory and some measures of executive functions (inhibitory control) and approximately half of the studies also detected verbal memory impairment.Conclusions. There are subtle differences between the two subtypes regarding cognition. This may suggest neurobiological differences between the two subgroups which will be helpful in order to determine cognitive endophenotypes in BD subtypes.

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“…When Bipolar II was introduced into the DSM in 1994, some argued that it should be considered a variant of Major Depression (Kupfer, Carpenter, & Frank, 1988). Recent data identifying genes associated with Bipolar I and Bipolar II suggest that common genes are not identified according to Vieta & Suppes (2008). Judd et al (2003) concur that current genetic evidence suggests that Bipolar I and Bipolar II do not share a Evidenced-based 7 common genetic diathesis.…”

Section: How the Change In Diagnostics Created An Epidemicmentioning

confidence: 99%

Is There Evidence for the Bipolar Spectrum and the Safety of Pharmaceutical Interventions?

Littrell

2012

Social Work in Mental Health

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Bipolar II disorder: arguments for and against a distinct diagnostic entity

Abstract: Bipolar II disorder is supported as a distinct category within mood disorders, but the definition and boundaries deserve a greater clarification in the DSM-V and ICD-11.

Cited by 178 publications

References 147 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Are bipolar II patients cognitively impaired? A systematic review

Is There Evidence for the Bipolar Spectrum and the Safety of Pharmaceutical Interventions?

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