Access to care barriers for patients with Bipolar disorder in the United States.

BACKGROUND: The five major comorbidities associated with Bipolar Disorder (BPD) include anxiety disorder, substance abuse, attention deficit hyperactivity disorder, personality disorder, and other medical conditions. These conditions are extremely prevalent among patients with BPD. Additionally, the medications used to treat this disorder can cause severe weight gain, which leads to cardiovascular disease, type 2 diabetes, and other endocrine disorders. PURPOSE: The purpose of this paper is to inform the medical community and health policymakers of the causes and comorbidities associated with BPD; stigma, acceptance of insurance, shortage of providers and costs as barriers to access care; and the collaborative care model and policy-based solutions to improve the access to high quality care and the quality of life of people living with bipolar disorder. RESULTS: Recent policy developments that address mental health in the United States, such as, the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Helping Families in Mental Health Crisis Act are opportunities to improve access to care. Though not specifically targeting BPD, collaborative programs and mental health policies can start monitoring the comorbidities associated with BPD. By focusing on prevention and collaborative care, providers can slow the acceleration of symptoms and allow for quicker channels of treatment for comorbidities.

The effect of vasopressin upon the vasculature of the isolated perfused rat kidney.

The timed uptake of (131)I-labelled human serum albumin was used as an index of regional perfusion in the isolated rat kidney.1. Arginine vasopressin in doses of 1, 5 and 10 muu./ml. of perfusate decreased papillary perfusion. Total renal perfusion was decreased only by the 5 muu. dose.2. Ornithine-8-vasopressin in doses of 5 and 10 muu./ml. of perfusate decreased papillary perfusion. Total renal perfusion was decreased only by the 10 muu. dose.3. When the relative viscosity of the perfusate was increased to a value of 2.0 from the control value of 1.7, both papillary perfusion and total renal perfusion were reduced.4. Arginine vasopressin further reduced papillary flow in kidneys perfused with high viscosity artificial plasma.