Relationship With Patient Can Determine Treatment Success

Aaron Levin


An understanding of the patient’s values and the place of medication in a wider therapeutic program in which medication is one tool for recovery should inform a psychiatrist’s judgment.

Abstract Teaser

Medications may help psychiatric patients get better, but “getting better” is a “profoundly value-laden term,” said Ronald Diamond, M.D., a professor of psychiatry in the School of Medicine and Public Health at the University of Wisconsin.
“ ‘Better’ means different things to different people,” said Diamond at APA’s Institute on Psychiatric Services in New York in October.
“You and the patient might disagree not on what is happening but on its value,” he said. “It could be subjective improvement for the patient, better functioning, symptom improvement, reduced distress, or simply not getting worse.”
Medications are a tool for recovery and can make nonpharmacological treatments more effective, possibly by making the brain less sensitive to stimuli, he said.
“Medications are never a goal of treatment; rather, they can help patients reach their own goals,” he said. “Ambivalence about medications is normal, but people will take them if they feel they will help them and won’t if they don’t.”
All medications have potential risks as well as benefits, so side effects are best seen from the patient’s point of view. To read more, click here.

Research redefines ‘recovery’ in bipolar disorder

Researchers have developed the first accurate tool for measuring bipolar recovery which takes into account the personal experiences of people living with the disorder.
The Lancaster University-led research team worked with people with bipolar disorder and clinicians to develop the 36 item bipolar recovery questionnaire (BRQ) to reflect changing attitudes to what counts as ‘recovery’ in a severe mental illness such as bipolar.

The questionnaire, which was then tested by 60 people with bipolar, focusses on personal definitions of recovery rather than symptom reduction and relapse prevention. It is the first self-report tool specifically designed to capture the subjective experience of recovery in individuals with bipolar disorder.

In tests it has proved to be a reliable tool, higher BRQ recovery scores were associated with lower depression and mania scores as well as higher wellbeing, better functioning, better mental health quality of life and personal growth.
The results of the study are published this month in the Journal of Affective Disorders.

Professor Steven Jones of Lancaster University’s Spectrum Centre – a bipolar research centre dedicated to research which can improve the day to day lives of people living with this condition – – led the work.

He said: “The importance of personal recovery, rather than recovery as defined by an expert, in mental health is increasing widely recognised.

“But until now there has been no measure available to assess recovery experiences in individuals with a diagnosis of bipolar disorder.

“For some people recovery means getting back into the gym for the first time in five years, for others it is rebuilding successful relationships with family or getting back into paid work.

Click here to read more.

Psychiatrists approve vast changes to diagnosis manual

11:40PM EST December 2. 2012 – Asperger’s is out, but binge eating and hoarding are in as official mental disorders in the latest version of the diagnostic bible published by the American Psychiatric Association, following a weekend vote by its board.
The Diagnostic and Statistical Manual of Mental Disorders — whose latest edition is nicknamed DSM-5 — is often called the “bible” because it’s used to identify and classify mental disorders.
The vote gives only a hint of the massive changes that will be unveiled in detail in May when the guide is published. The last full revision was in 1994, with minor changes approved in 2000.
The revisions have been considered for more than a decade. Among the changes are:

Eliminating the mild form of autism known as Asperger’s syndrome per se and including it as part of the autism spectrum disorder. To read more, click here.