The National Institute for Health and Care Excellence (NICE) recently issued updated guidelines offering evidence based advice on the treatment and children care, adolescents and adults suffering from bipolar disorder. The guidelines feature aspects of both, primary and secondary care. However, after an analysis of the evidence upon which these psychological treatments have been recommended, certain scientists claim them to be significantly flawed in their methodology and meta-analysis.
How To Control Bipolar Disorder: Understanding The Condition
Bipolar disorder is a lifelong and potentially debilitating condition. It is mainly characterized by episodes of mania (abnormally heightened mood, increased irritability, symptoms of functional or psychological impairment) or hypomania (manic episodes lasting for about four days or more) and episodes of extensive depression. The disorder is often comorbid with anxiety and personality disorders, substance misuse and attention deficit hyperactivity disorder (ADHD).
The lifetime prevalence of bipolar disorder, characterized as mania and depression is approximately one percent of an adult population, and that of hypomania and depression is about 0.4 percent.
The peak age of onset for the disorder is between 15 and 19 years – the condition rarely develops in children under the age of 12. What’s concerning is that there is generally a significant delay between the onset and subsequent contact with mental health services.
Revised Guidelines For Bipolar Disorder
Since the publication of the previous NICE clinical guidelines in 2006, certain key advances have been made in the approaches of care and treatment for people with bipolar disorder. The recommendations are applicable to patients of bipolar I, II and mixed affective and rapid cycling disorders. These revised guidelines cover the following main aspects:
- Recognition, assessment and management of the disorder in children, adolescents and adults.
- Specific recommendations for diagnosing bipolar disorder in children and adolescents due to differences in presentation of symptoms and varied complications from other disorders such as ADHD.
The guidelines focus solely on treating and managing bipolar disorder, and do not deal with psychiatric disorders that co-exist with the condition.
Ways to Control Bipolar Disorder– List Of Quality Statements Under NICE Quality Standards
These standards encompass the recognition and early treatment and intervention of bipolar disorder. The key statements issued are listed below:
Statement 1: Children and adolescents referred to a mental health service after their first episode must start assessment within two weeks.
Statement 2: Their families, and the children and adolescents who have experienced their first episode must be provided family intervention.
Statement 3: Newly diagnosed children and adolescents must be provided psychological intervention as soon as possible.
Statement 4: Parents and caretakers of children and adolescents diagnosed with bipolar disorder are given relevant educational and support information.
Statement 5: Children and adolescents diagnosed with bipolar disorder are given advice relating to a healthy lifestyle at the time of diagnosis and their annual review.
Statement 6: Children and adolescents with bipolar disorder who have been prescribed antipsychotic medications must be monitored for side-effects.
Statement 7 (Developmental): Children and adolescents with bipolar disorder suffering from a crisis are offered treatment at home, if suitable.
Statement 8: Children and adolescents with bipolar disorder must have arrangements for accessing employment-related training and education included in their primary care plan.
The guidelines issued by NICE cover a variety of aspects about the diagnosis, treatment and management of bipolar disorder. They seem to have updated the recommendations based on the need for primary care and assistance for families living with a patient. Whether the guidelines have been issued after scrutinizing reasonable evidence remains under debate by researchers. Only the effectiveness of the guidelines after their implementation will help resolve this issue.