Bipolar Disorder

References

¹ Fountoulakis KN, Yatham LN, Grunze H, et al. The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder. Int J Neuropsychopharmacol. 2020;23(4):230-256. doi:10.1093/ijnp/pyz064

² Grunze H, Vieta E, Goodwin GM, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Acute and long-term treatment of mixed states in bipolar disorder. World J Biol Psychiatry. 2018;19(1):2-58. doi:10.1080/15622975.2017.1384850

³ Malhi GS, Bell E, Boyce P, et al. The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders: Bipolar disorder summary. Bipolar Disord. 2020;22(8):805-821. doi:10.1111/bdi.13036

⁴ Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266-280. doi:10.1016/j.jad.2017.03.052

⁵ Yatham LN, Kennedy SH, Parikh SV, et al. 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. Bipolar Disord. 2018;20(2):97-170. doi:10.1111/bdi.12609

Pathway does not replace clinical judgment and should be modified as needed for individual patients. Page last revised 7/6/11 .
Please send comments to: piercerp@health.missouri.edu

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Published by the Department of Family & Community Medicine , Columbia, MO 65211

Assess for a history of manic or atypical symptoms:

atypical depression: hypersomnia, hyperphagia, psychosis, age < 15 yrs
social history: multi-substance abuse, chaotic personal life (>2 divorces; multiple relationships)
family history: bipolar disorder or multiple family members with psych disorders
treatment: no response to > 2 antidepressants, atypical (rapid) response to antidepressants

Suicidality
Homicidality
Inability to care for one's self

Instructions on how to get to MDQ in PowerChart:

Access to MDQ from Patient Chart in PowerChart:

Click "Ad Hoc" button located on toolbar
"Ad Hoc Charting" pop-up window will appear
Double-click "Provider Forms" folder
Select "Mood Disorders Questionnaire (Bipolar)"
Click on "Chart" button
MDQ form appears in new window to be completed by patient or with patient
Scoring is explained within the charting window
Upon completion of form, click the green checkmark in upper left corner to complete and chart results
To pull results into any PowerNote free text area in the patient's chart, type: ..mdq and hit return

Symptoms such as increased energy, pressured speech, flight of ideas, racing thoughts, grandoise throughts, irritablitiy

Symptoms such as depressed mood, loss of interest in pleasurable activities, fatigue, feeling of worthlessness

Well-documented history of bipolar disorder or positive MDQ but currently without criteria for either mania or major depression