Difficulties in Diagnosis and Management of Bipolar Disorder: Three Case Presentations

Bipolar disorder is associated with significant problems in patient management, including misdiagnosis,noncompliance, and comorbid substance use disorders. This article describes strategies forthe management of difficult cases, with particular emphasis on the choice of therapeutic agents, suchas mood stabilizers and atypical antipsychotics, for optimal control of symptoms and psychosocialinterventions for reinforcement of therapeutic interventions. Special attention is given to the relationshipbetween bipolar disorder and substance use disorders.