Bipolar II Disorder: Modelling, Measuring and Managing, 2nd ed
The first edition of this book was published in 2008, and this timely update provides a wealth of information regarding a relatively understudied mood disorder—bipolar II. This volume consists of 32 chapters and includes 13 interesting commentaries regarding management by well-known authorities in this field. Two models for management are presented, one by Professor Parker, and one by Ketter and Wang. It seemed to me that there was large consensus regarding management as well as issues relating to diagnosis.
Bipolar II disorder remains a largely underdiagnosed condition even after proposals for its definition began in the early 1970s and bipolar II was accepted into DSM-IV in 1994. The depressive episodes incurred by subjects with bipolar II disorder are usually recognized, but hypomania is often not detected by clinicians. One helpful hint underscored in this volume is to interview subjects in the presence of relatives or significant others in order to both confirm the diagnosis and obtain a more accurate family history that would help the clinician suspect the diagnosis. The book also points out the importance of inquiring about hypomania rather than destructive manic episodes. Hypomania typically follows or precedes depressive states, and the clinician should suspect bipolar II disorder as the correct diagnosis in individuals who have a history of multiple depressive episodes or more than 1 major depressive episode in a year (rapid cycling).
Other aspects of treatment discussed involve pharmacotherapy (Parker advocates a trial of a selective serotonin reuptake inhibitor first), including mood stabilizers (especially lamotrigine and lithium) and second-generation antipsychotic medication (especially quetiapine and olanzapine—the volume predates the more recent data regarding lurasidone). Having patients complete a mood calendar, providing psychotherapy (such as cognitive-behavioral psychotherapy), and providing psychoeducation and "well-being plans" are also part of the package regarding management. I agree wholeheartedly with all of the above points.
Bipolar II Disorder: Modelling, Measuring and Managing is an important and comprehensive volume. I recommend it to trainees in mental health as well as practitioners whose focus is on mood disorders.
Author affiliation: University of Washington School of Medicine, Seattle.
Potential conflicts of interest: None reported.
J Clin Psychiatry 2014;75(5):e465 (doi:10.4088/JCP.14bk09063).
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