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유빈,김진이,조현상 대한우울조울병학회 2008 우울조울병 Vol.6 No.1
Objectives:Pharmacotherapy is efficacious for acute treatment of bipolar disorder, but still limited for the relapse prevention. Early detection of relapse and its management have been included as one of major strategies in recent psychosocial treatments of patients with bipolar disorder. The detection of manic prodromes can be useful for the early intervention. The aim of this study was to interview and report on prodromal symptoms in a recent manic episode. Method:43 euthymic bipolar patients were interviewed about a variety of their prodromes of manic states, with open questions and a prodrome checklist. Results:All of the subjects could detect the prodromes of mania and their prodromal symptoms were diverse. Most common manic prodromes were the symptom of decreased need for sleep and more talkative observed in 75% of the bipolar subjects. Some patients reported depressive symptoms in the initial prodromal period. Conclusion:Bipolar subjects reported a variety of and diverse prodromal symptoms of manic episode. Psychosocial treatments, especially including education for early detection of manic prodromes and programs for their proper management will be needed for relapse prevention.
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유빈,조현상 대한우울조울병학회 2008 우울조울병 Vol.6 No.2
In the past, bipolar disorder was understood as an episodic illness involving complete interepisode recovery of the mood and function. But recent studies have focused on the poor functional outcome of bipolar patients, and some researchers think that the poor outcome of bipolar patients may result from the persistent cognitive impairment during symptomatic remission. The cognitive impairment has great importance in patient’s prognosis, because it directly influences their psychosocial functioning. The etiology of cognitive impairment in bipolar patients can be classified into iatrogenic, acute functional changes associated with depression or mania, permanent structural lesions of the neurodegenerative origin or neurodevelopmental origin and permanent functional changes mostly genetic in origin. We reviewed these causes in this article. Recent treatment strategies are designed to target these causal factors. Generally. the dopaminergic, anticholinergic, and glutamatergic drugs are used in the laboratory fields now. Some studies reported the efficacy of these medications for cognitive improvement in bipolar patients, but these studies were not sufficient to confirm the efficacy of the pharmacotherapy. We also reviewed the rationale and efficacy of the various psychopharmacotherapies to improve the cognitive function of patients with bipolar disorder. In conclusion, psychopharmacotherapy will be the future plan for the treatment of cognitive impairment of bipolar patients.
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