Describe the history of the present illness (HPI) and clinical impression for the client.

Assignment: “Captain of the Ship” Project – Bipolar Disorders

Bipolar disorders are severe disorders of mood that include both depressive episodes and expansive, grandiose, or manic episodes. During these times, the person may engage in activities with little awareness of the consequences because of accompanying psychosis. A diagnosis of bipolar disorder includes periods of mania or hypomania and periods of depression where the mood is down, hopeless, and suicidal. The neurovegetative symptoms of bipolar depression can be incapacitating. It is also important to differentiate the psychosis of bipolar disorder from schizophrenia.

In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a bipolar disorder.

Assignment

For this Week– you will have an opportunity to develop a ‘Captain of the Ship’ project for Bipolar Disorder. Treating bipolar disorder can be a challenge and that is why we use recent research articles and algorithms to help us decide on medication options for patients. It is very important to try to select the appropriate medication on the first go-round. Otherwise, patients become frustrated and discouraged because of the length of time that is needed to determine effectiveness. Please do not used outdated articles, so that you can choose an effective and well-tolerated medication.

Remember (1) that there is an excellent example for ‘Captain of the Ship’ project attached with this ASSIGNMENT, BUT WRITTEN ON A DIFFERENT DISORDER. (2)

Here are your instructions:

This week, you will once again become “Captain of the Ship” as you take full responsibility for a client with a bipolar disorder by presenting the assessment of the client, recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs, collaborative actions, community support, and recommending follow-up plans.

Instructions:

To prepare for this Assignment

Select an adult or older adult client with a bipolar disorder that you have seen in your practicum/clinical rotation site.

In 3-4 pages, write a treatment plan for your client. In which you do the following:

· Describe the history of the present illness (HPI) and clinical impression for the client.

· Recommend psychopharmacologic treatments based on evidence-based practice and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).

· Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

· Identify medical management needs, including primary care needs, specific to this client.

· Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

· Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

N: B. (1)The Captain of the Ship project needs to show that you are evaluating the patient, making a diagnosis, providing treatment plans and outcomes as well as collaborating with other providers. The project MUST meet all these requirements. (2) The choice of medications should be clear, and the medical management should be clear. (3) Consider using the bipolar disorder algorithm from http://www.psychiatrictimes.com/bipolar-disorder/new-psychopharmacology-algorithms

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 8, “Mood Disorders” (pp. 347–386)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

· Chapter 13, “Acute and Maintenance Treatment of Bipolar and Related Disorders”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Bipolar and Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Bipolar depression

Bipolar disorder

Bipolar maintenance

Mania

amoxapine aripiprazole armodafinil asenapine bupropion carbamazepine fluoxetine iloperidone lamotrigine lithium lurasidone modafinil olanzapine olanzapine-fluoxetine combination quetiapine risperidone sertindole valproate (divalproex) ziprasidone

alprazolam (adjunct) amoxapine aripiprazole asenapine bupropion carbamazepine chlorpromazine clonazepam (adjunct) cyamemazine doxepin fluoxetine flupenthixol fluphenazine gabapentin (adjunct) haloperidol iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct)

loxapine lurasidone molindone olanzapine olanzapine-fluoxetine combination oxcarbazepine paliperidone perphenazine pipothiazine quetiapine risperidone sertindole thiothixene topiramate (adjunct) trifluoperazine valproate (divalproex) ziprasidone zonisamide zotepine zuclopenthixol

aripiprazole asenapine carbamazepine iloperidone lamotrigine lithium lurasidone olanzapine olanzapine-fluoxetine combination quetiapine risperidone (injectable) sertindole valproate (divalproex) ziprasidone

alprazolam (adjunct) aripiprazole asenapine carbamazepine chlorpromazine clonazepam (adjunct) iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct) lurasidone olanzapine quetiapine risperidone sertindole valproate (divalproex) ziprasidone zotepine

Marsee, K., & Gross, A. F. (2013). Bipolar disorder or something else? Current Psychiatry, 12(2), 43–49. Retrieved from http://www.mdedge.com/currentpsychiatry/article/66320/bipolar-disorder/bipolar-disorder-or-something-else

Miller, L. J., Ghadiali, N. Y., Larusso, E. M., Wahlen, K. J., Avni-Barron, O., Mittal, L., & Greene, J. A. (2015). Bipolar disorder in women. Health Care for Women International, 36(4), 475–498. doi:10.1080/07399332.2014.962138

Schouws, S. M., Comijs, H. C., Dols, A., Beekman, A. F., & Stek, M. L. (2016). Five-year follow-up of cognitive impairment in older adults with bipolar disorder. Bipolar Disorders, 18(2), 148–154. doi:10.1111/bdi.12374

Ward, I. (2017). Pharmacologic options for bipolar disorder. Clinical Advisor, 20(3), 17–25.

Required Media

Laureate Education (Producer). (2017d). A young woman with depression [Multimedia file]. Baltimore, MD: Author.

Redfield Jamison, K. (Producer). (n.d.). Assessment & psychological treatment of bipolar disorder [Video file]. Mill Valley, CA: Psychotherapy.net.

Optional Resources

Malhi, G. S., McAulay, C., Gershon, S., Gessler, D., Fritz, K., Das, P., & Outhred, T. (2016). The lithium battery: Assessing the neurocognitive profile of lithium in bipolar disorder. Bipolar Disorders, 18(2), 102–115. doi:10.1111/bdi.12375

Samalin, L., de Chazeron, I., Vieta, E., Bellivier, F., & Llorca, P. (2016). Residual symptoms and specific functional impairments in euthymic patients with bipolar disorder. Bipolar Disorders, 18(2), 164–173. doi:10.1111/bdi.12376

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