Talk:Bipolar disorder/Archive 7

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Archive 7
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Contents

Removing specific DSM criteria

I have had an on-going discussion with the permissions people at the APA, and they are adamant about refusing to give Wikipedia permission to display or publish the DSM diagnostic criteria, or any version thereof, even if the area where that information is displayed is locked and uneditable.

That said, and to avoid potential litigation, I would like to remove the criteria listed on this page, and insert a link to the "official on-line page" and boilerplate explaining that outlink. Kindly see the DID page for an example.

Comments? Objections? Support? --Mjformica 12:06, 2 March 2006 (UTC)

First, what is 'the DID page'? Are DSM diagnostic criteria to be removed from ALL mental illness articles? Are all mental illness articles to now have NO diagnostic criteria from now on? Anarchist42 19:00, 2 March 2006 (UTC)


DID = Dissociative identity disorder, and, yes, all DSM criteria are to be removed from all mental health articles, per the APA. Diagnostic criteria will be outlinked to the APA site. --Mjformica 21:46, 2 March 2006 (UTC)
OK, revisit...that was me being harsh and abrupt again...the APA has adamantly proscribed that Wikipedia not display the criteria in the DSM and that the sources should be outlinked to an authorized site.
Those definitive "are"s and "will"s on my part would better serve us as "should"s and "ought"s. --Mjformica 22:43, 2 March 2006 (UTC)
Can you please provide a link about the new APA policy regarding the DSM criteria? I do not believe that simply linking to an arguably biased source is sufficient for such important information as diagnostic criteria for serious illnesses. Anarchist42 17:44, 3 March 2006 (UTC)
It's not a policy, and it's not new. It's a question of copyright infringement. When referencing copyright material of any sort, you need permission from the source. APA will not give Wikipedia permission. Period. This is an on-going conversation that I have had with their Permissions Department regarding my own sites, and one I've broached with them re: Wikipedia...even if the information is placed on uneditable pages, then answer is a resounding, "No.".
As for the "arguably biased source"...well, they've got permission. Go figure. If you can find a better link, have at it. I haven't been able to find one, frankly. Cheers! --Sadhaka 14:26, 12 March 2006 (UTC)

External links

All the external links were removed by a recent edit by User:Barrylb without any prior discussion. Was this accepted by other members? A quick glance showed the links nicely organized without spam links. Maybe some did need to be taken out, but I don't think removing all of them is a good idea. Comments? Gflores Talk 22:02, 2 March 2006 (UTC)

I added some boiler plate to accomodate the directory linking format. See what you think. I believe the intention here was a good one, and supports comments made by others re: external link policy and the number of links (previously) on this page. I dropped Barrylb a note to heads him up on what was done to accomdate the directory concept here. Maybe the ODP will pick up on it. —The preceding unsigned comment was added by Mjformica (talk • contribs) .
Oops...sorry, thanks. --Mjformica 22:51, 2 March 2006 (UTC)
There was NO DISCUSSION at all! True, there were too many redundant links, but some were valuable references. Anarchist42 17:47, 3 March 2006 (UTC)
True, but there was also no delete. Technicaly, what Barry did was a re-direct. And it is a redirect supported by a Wiki-Project. Conundrum. --Sadhaka 14:27, 12 March 2006 (UTC)

List of support groups

I've moved this from the article. Does anybody think it belongs there? It was moved from Bipolar disorder support groups. -- Barrylb 01:17, 12 March 2006 (UTC)

Support groups

Patients with bipolar disorder often find comfort in support groups. Since it is sometimes difficult for them to find a support group in their local area, many support groups have been started on the internet, including:

Useful Link

We have just added article and video content created by key opinion leader Physicians as well as government health organizations and would like to be considered as a useful resource for this page. We are hosting an online symposium on mental health and spirituality and think this would also be a valuable contribution to the community.

Thank you,

Ryan

Depression Treatment

Ketogenic Diet

The section called ketogenic diet indicated that a study was underway at Standford University. The correct university is Stanford. Here is a link to the study Stanford University Bipolar Disorders Clinic: Ketogenic Diet in Bipolar Depression [1]

Also, If you are taking Depakote, check with your doctor before starting a ketogenic (Low Carb) diet. My personal experience was a 75% reduction of Depakote's efficacy. Since this was my primary defense against mania, I quickly became hospitalized.

Changes without discussion

There seems to be massive changes to the article by User:70.95.218.47 and User:Rob.towers.

Significant changes to the article should be discussed on the Talk page. --WikiCats 02:22, 9 April 2006 (UTC)

re changes

The additions I (User:70.95.218.47 and User:Rob.towers are the same individual) made are for this article are intended to increase the pages timeliness, readability, usefulness and higher ranking in search engines such as Google.

Additions from others are both welcome and helpful.

Rob

Is there a major focus of how a page ranks in search engines? I have never seen that as a justification before. Sparkleyone 06:34, 9 April 2006 (UTC)

Making extended or significant changes are of concern to other editors. Every edit to Wikipedia is checked by other editors. Making numerous changes over many days makes it very hard for others to check your work. Please propose major changes on the Talk page. You risk having your work reverted. --WikiCats 07:05, 14 April 2006 (UTC)

Changes to unify article

I have a concern about this article. First, this subject is continually evolving because it is a very hot topic in the psychiatric literature right now. So there's really a lot of information. In particular, this page seems to be very broad. I've looked at the "Diabetes" page and it is organized quite clearly and cogently. I have decided to stop making adjustments to the page because I need more input from others.

Contents [hide] 1 Etiology or causes 2 Two personal descriptions of the bipolar experience 3 History of the bipolar disorders 4 A new epidemiology: bipolar spectrum disorder 5 Domains of the bipolar spectrum 5.1 Bipolar depression 5.2 Hypomania 5.3 Mixed state 5.4 Mania 5.5 Rapid and ultradian cycling 5.6 Cognition 6 Misdiagnosis and the treatment lag 7 Avoiding misdiagnosis and the current diagnostic criteria 8 Current diagnostic criteria for bipolar disorder 9 Suicide risk

10 Treatment of bipolar disorder *****[should be removed]


11 Comorbid or co-existing conditions 12 Treatment of bipolar disorder *****[placement here makes sense] 13 Prognosis and the goals of long-term treatment 14 Avoiding relapse


15 Research findings *****[candidate for a related article ? ] 15.1 Heritability or inheritance of the illness 15.2 Recent genetic research 16 Current and ongoing research 16.1 Medical imaging 16.2 Personality types or traits 17 Research into new treatments


18 Bipolar disorder and creativity ***** [important but candidate for a related article ? ]


19 Sources 20 References 21 Further reading 22 See also 23 External links


For people who would like to edit this further I'd be interested as well. I'm a first-timer at wikipedia. So any help would be appreciated.

Thanks.

rob

Surely you need to have a description of the disorder before you launch into personal accounts, etiology and history? I would propose that you have

- Brief history

- Domains of bipolar spectrum

- DSM-IV diagnostics (with sub-section 'Reasons for possible misdiagnosis' with a more NPOV take)

- Etiology

- Treatment (with sub-sections 'prognosis', 'avoiding relapse', 'suicide risk' - Wiki is not a self help book, there doesn't need to be half a page of "what to do if you're feeling suicidal")

The research stuff should be in it's appropriate sections - e.g. do we need a whole section on research in heritability when these findings could be discussed in the etiology section?
Oh, and surely we don't need all of 'sources', 'further reading', 'references', 'see also' and 'external links'? Can't we have some nice shiny footnotes like other articles use?
This page is a shambles, and thank god the millions of edits have ceased. I'm all for reverting back to the article the way it was a few weeks ago, there was a great order and flow then. Okay, rant over. Sparkleyone 05:24, 17 April 2006 (UTC)

It seems like there is great repetition between the Bipolar depression and Mania sections within Domains of the bipolar spectrum. What is called psycosis in Bipolar depression seems to be the same thing as what mania is talking about, they should probably be combined it seems. An7drew 01:13, 25 October 2006 (UTC)

SEX

Is it true that someone with a bipolar disorder cannot control their sexual urges. If anyone can answer this question, it would help my relationship immensly. Thanks


I was just wondering if anyone out there could help me. I am engaged to a very beautiful women who was recently diagnois with bipolar. She was told that because of her disorder, she would not be able to control some of her feelings or actions. She was also told that she would have highs; where she felt untouchable and COULD do about anything she wanted. Other times she would have lows (manic depression); where she WOULD do just about anything. What I would like to know is; "Can her manic episodes be controlled?"

I have BP II - I was BP I at first, I got better over time, with the help of the meds most likely, to the point where I'm just a BP II now. It is important to note the different between BP I and BP II - BP I is the level of severe mood swings, BP II is the level of low to moderate mood swings. The difference in size of the mood episode, between BP I level and II level, in my experience, is the same as a 9.0 on the Richter scale for an earthquake (BP I level), compared to a 3.0 for BP II. So BP is not a one size fits all illness, and the cycles, as this wikipedia document so eloquently details, vary greatly between BP's, in terms of frequency and intensity. I think it is 100 percent false to say that a BP cannot control themselves. In any area, sexual or otherwise. The only thing that is out of control is the mood. The teacher in Florida, IMO, who is having her attorney use BP as an excuse for having sex with a student, is using the BP as an excuse. Otherwise, you'd hear about statistics linking pedophiles with bipolar disorder, which is simply not the case. In fact, the large majority of crimes are committed by persons who do not have mental illnesses. It's just that defense attorneys like to use the "insanity" defense when they have no other defense available. So the mentally ill get a bad rap as a result, hence part of the stigma associated with mental illness.
Wikipedia is not a doctor's office. If your friend thinks she cannot control her behavior, she should take advice from her doctor. Perhaps a patient support group, or a support group for friends and relatives of bipolars, as well as couple counseling (with a therapist who has a good knowledge of this disorder and its influence on intimate relationships) could help you. Apokrif 14:44, 16 April 2006 (UTC)
You can't tell someone with an eating disorder to stop eating or eat more. Sexual addiction (or lack of interest) is very real. If she is currently seeing a pDoc, then she needs to address these issues as they occur. Telling signs are hypomanic behavior and well thought excuses.

Angst study

i have removed the following section from the article, as the reference does not have any of the stated findings. can anyone provide the correct cite? I have done a fair search for this guy, but none of the research from his team seems to have these conclusions that I could see. Sparkleyone 03:05, 27 April 2006 (UTC)

There is also a well-supported clinical view that clinical depression become bipolar disorder over time. In a 2005 study, Jules Angst and his colleagues at Zurich University tracked 406 patients with major mood disorders over a 20-year period.[1] Of 309 patients presenting with depression, 121 (39.2 percent) eventually manifested as bipolar (24.3 percent to bipolar I, 14.9 percent to bipolar II). In all, more than 50 percent of the study population turned out to have bipolar disorder. This supports the view that most cases of bipolar disorder are initially misdiagnosed as depression.

This section contradicts itself. "...clinical depression become[s] bipolar disorder...." vs "...most cases of bipolar disorder are initially misdiagnosed as depression." [emphasis mine] Ted 13:11, 27 April 2006 (UTC)

The apparent contradiction may stem from the fact that clinicians tend to believe that their initial diagnoses are correct and bipolarism happens later, whereas patients tend to believe that they were always bipolar and they were initially misdiagnosed. Anarchist42 17:05, 27 April 2006 (UTC)

Article change re bipolar disorder and atypical antipsychotics

The following sentence seems to be oddly worded, and I have changed it:

The prognosis for bipolar disorder is, in general, better than that for schizophrenia, but some individuals with schizophrenia respond remarkably well to the atypical antipsychotics which are also used in bipolar disorder.

"Bipolar disorder" at the end of this sentence should be changed to "bipolar mania," as there is no evidence that it helps treat bipolar depression. This sentence also might lead some to believe that atypical antipsychotics were first developed for bipolar disorder. This is patently untrue, at least in the United States, where the indication for bipolar mania of the atypicals came fairly recently. Frankieist 08:18, 30 April 2006 (UTC)

Ahem,

Joseph Calabrese's group found quetiapine to be robustly superior to placebo for treating bipolar depression.

Thought you should know.

Article Pub Med Link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15994719&itool=iconabstr&query_hl=1&itool=pubmed_docsum

But about my grammar, you're right that sentence sucked. Thx for revision.

Rob

WHOLE PERSON HEALING: LETTING GO FOR LIFE

Im removing this section for a couple of reasons. 1) obviously original research. 2) what isn't is redundant. 3) has not been thoughtfully added - it's a direct copy and paste from an online message board in a poor choice of section, and most of it is unreferenced and often irrelevant. If anyone wishes to revert me please do so, but please please please clean it up a lot before you leave it.Sparkleyone 09:26, 30 April 2006 (UTC)


I agree with the removal. --WikiCats 10:56, 30 April 2006 (UTC)


Apparently Barrylb likes to remove helpful external links. There was a link to havard's bipolar clinic webcasts which in had a webcast talk re promising new meds for bipolar depression. I'm not sure what Barry's deal is but he'll be getting a cc of this. There was also a UCLA Bipolar Grand Rounds webcasts. This is stuff your doctor probably hasnt seen. It could make the differnce in you or your loved one's condition.

Oh yeah, there's a link to the 6th int'l conference on bipolar disorder webcast. —The preceding unsigned comment was added by 70.95.192.152 (talk • contribs) .

I suggest you include the "stuff your doctor probably hasnt seen" in the article itself and provide these links as references. -- 14:49, 5 May 2006 (UTC)

Comments interpolated within article

The lengthy unsigned comment quoted below, which I have cut from the article and moved here, had previously been interpolated into the text of the article. -- Karada 23:41, 5 May 2006 (UTC)

An important rebuttal to this statistical critique of the Epidemiological Catchment Area study retabulation needs to be made. First, the collaborators on the original and follow-up study have international reputaions and are known for world-wide leadership and excellence in their fields. For example, the first Epidemiological Catchment Area study involving over 20,000 people was headed by Harvard Medical School Epidemiologist Ronald Kessler Ph.D. in collaboration with other stellar individuals from Columbia, Johns Hopkins and Yale Universities. Second, the more recent retabulation effort was led by Lew Judd M.D., former Chief of the NIMH, editor of many current Chair of the Department of Psychiatry at the School of Medicine at the University of California, San Diego. His co-investigator on the retabulation was international mood disorders expert, former NIMH researcher, Editor in Chief of the Journal of Affective Disorders and Professor of Psychiatry at the School of Medicine at the University of California, San Diego.Hagop Akiskal M.D. So, the likelihood of having made type I errors or type II errors with the resources available to Dr Judd and Dr Akiskal is unlikely. Furthermore, a project of this size, (again, over 20,000 people) funded by the federal government is unlikely to utilize ineffectual statisticians or statistal software. Regarding your other claims: 1)There is no need for researchers to do fieldwork of this size. 2)The "substantive" limitations claim is baseless: have you looked at the methodology? 3)The study was in survey format so structured interviews were necessary to reduce bias. 4)Why don't you listen to Ronald Kessler yourself in his presentation during the 6th International Bipolar Confernence. This is a webcast (scroll down to symposium III at 8:45 am Jules Angst is 2nd and Kessler is 4th.

My changes to Diagnosis

I've just made a minor change to the page. There were three main headings near the bottom of the page that concerned diagnosis (two of them were just 1 paragraph long!). I've created a new section, "Diagnosis" before etiology and incorporate all three as sub-sections. Apart from a duplicate sentence, the content remains identical. I think the same should be done for research, but I can't be bothered :) Matt Peacock 23:03, 10 May 2006 (UTC)

edit: Ok I've kept the new structure but moved diagnosis back to it's previous location. Although I strongly feel diagnosis should be much nearer the top, doing so would require moving other parts of the article to maintain readability and I don't want to tread on any toes.

Found unrelated off topic sentence. Should it be removed?

The following paragraph (fourth up from the bottom in the 'Etiology or causes' section) has an odd unrelated sentence at the end; (questionable text in italics)

"Seasonality or exposure to daylight also affects mood in bipolar disorder. In untreated individuals, the bipolar cycle tends towards mania in the mid-to-late-summer, followed by depression in autumn and winter (due to decreasing natural light). There once was a man who liked to suck on straws because he was fixated at what Freud would call the "oral" stage."

Anyone else think it sounds a little strange and should be removed from article? --Smitten 11:37, 28 May 2006 (UTC)

Extro/Introverted

An evolving literature exists concerning the nature of personality and temperament in bipolar disorder patients, compared to major depressive disorder (unipolar) patients and non-sufferers. Such differences may be diagnostically relevant. Using MBTI continuum scores, bipolar patients were significantly more extroverted, intuitive and perceiving, and less introverted, sensing, and judging than were unipolar patients[citation needed]. This suggests that there might be a correlation between the Jungian extraverted intuiting process and bipolar disorder.

I thought bipolars were more introverted than most. Isn't this the case? --A Sunshade Lust 23:24, 12 July 2006 (UTC)

Nature or nurture?

"Having relatives with MD/depression doesn't prove it's genetic. It could indicate that such families have ways of thinking that induce the illness."

That point may validly be drawn from the detail presented, but if you familiarize yourself with the research on the topic the conclusion is unmistakable: bipolar disorder is strongly genetically determined. Adoption and twin studies can provide a control for the rearing environment (with twins you vary the inheritance and compare monozygotic concordance rates v. dizygotic rates) and with adoption studies you vary the rearing environment). See: Int Rev Psychiatry. 2004 Nov;16(4):260-83, Am J Psychiatry. 2004 Oct;161(10):1814-21, Am J Med Genet C Semin Med Genet. 2003 Nov 15;123(1):48-58.

large-scale deletions 25/7

I'm reverting all of these massive section deletions until justifcation is provided on the talk page - yes, the article is too long but taking out all that work without discussing it doesn't sit well with me.Sparkleyone 02:50, 25 July 2006 (UTC)

A Website Called Moodgym...

Hey, this is my first post or anything on here so I don't really know what your mean't to do. But I wanted to suggest adding a link to this site:

http://moodgym.anu.edu.au/

Its a bit like an online councilor and I've found it very useful, I'm not sure if everyone would but maybe its worth putting the link on for people to have a look at.

I suppose I could just put it on myself but I wasn't sure if thats what your mean't to do.

Any thoughts would be cool!

--Rasclart1 20:57, 28 July 2006 (UTC)

treatment section total crap

please forgive the language, but the treatment section is crap. crap is the unofficial term for all the little wiki rules i know it is breaking but am too impatient to learn. —Preceding unsigned comment added by Joeypruett (talk • contribs)