The expression of bipolar spectrum psychopathology in daily life.

BACKGROUND: Bipolar psychopathology has traditionally been defined by categorical diagnoses. However, these disorders may simply reflect the extremes of a broader spectrum of clinical and subclinical bipolar psychopathology. METHOD: The present study examined the validity of the Hypomanic Personality Scale (HPS) as a measure of bipolar spectrum psychopathology in 305 young adults using experience sampling methodology. The participants completed the HPS and were signaled randomly eight times daily for seven days to complete brief questionnaires on their current experiences. RESULTS: High HPS scores were associated with elevated energetic-enthusiasm, irritability, dysphoria, flight of ideas, mild grandiose beliefs, and risky behavior, as well as increased variability in affect in daily life. High HPS scores were also associated with greater reactivity in negative affect and behavior in response to viewing themselves as unsuccessful in their activities. LIMITATIONS: It is not clear to what extent the participants had diagnosable bipolar disorders. CONCLUSIONS: The findings support a broader spectrum of bipolar psychopathology and the validity of the HPS as a measure of this construct.

The integration of measurement and management for the treatment of bipolar disorder: a STEP-BD model of collaborative care in psychiatry.

Patients with bipolar disorder are among the most challenging to treat. These patients frequently present with complex mood and other symptoms that change over time, complex psychiatric and medical comorbid conditions, and multiple medications. Clinicians rarely systematically assess or measure all of these factors and instead rely on memory and general impressions. It is imperative that clinicians systematically track and monitor these relevant variables to ensure treatment decisions are based on precise clinical data. By integrating measurement and management, clinicians and patients can collaborate to assess the effectiveness of treatments and to make joint decisions about critical points at which to adjust treatment. This method was shown to be successful in the National Institute of Mental Health (NIMH) Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).