My Support - May 24, 2009

Patients With Bipolar Disorder Have Higher Specialty Care Costs Than Patients With Diabetes And Other Chronic Diseases

Mayo Clinic researchers have found that bipolar disorder (BPD) is a more costly chronic condition than diabetes, depression, asthma and coronary artery disease (CAD), based on a review of health care claim costs. http://www.medicalnewstoday.com/articles/151113.php
 

Come To the Fiesta del Sol and Learn about Fusion

Fusion will be hosting a booth at the Fiesta del Sol in Solana Beach on June 6th-7th. Enjoy the crafts, food and music at the Fiesta, and make a point to stop by Fusion's booth to learn more about our unique one-to-one school and tutoring programs, or just to say hi and meet our staff. The Fiesta del Sol is located at Fletcher Cove, at the intersection of Sierra and Lomas Santa Fe. Hope to see you there! Click here for more information http://sbfiestadelsol.net

Beyond the Border ICAF Special Program Announced: ReEnVisioning A World Beyond Borders - A Gen Y 3G Mobile Phone Photo Project

In collaboration with Qualcomm, International artist and project creator - Brenda Regier, and Beyond the Border International Contemporary Art Fair, we are proud to announce ReEnVisioning A World Beyond Borders, a digital photo project showcasing the artistic capabilities of 3G mobile phone technology. Selected photos will be exhibited as part of the large-scale mobile phone digital installation at the Beyond the Border International Contemporary Art Fair held September 2-4, 2009 at the Grand Del Mar hotel in San Diego.

San Diego, CA (PRWEB) May 1, 2009 -- In collaboration with Qualcomm, International artist and project creator - Brenda Regier, and Beyond the Border International Contemporary Art Fair, we are proud to announce ReEnVisioning A World Beyond Borders, a digital photo project showcasing the artistic capabilities of 3G mobile phone technology.

ReEnVisioning A World Beyond Borders will provide an opportunity for Generation Y (Gen Y) Qualcomm employees or Gen Y children of Qualcomm employees - ages 12 to 28 - to submit photos captured on a 3G mobile phone. Participants from all of Qualcomm's worldwide locations will participate by taking pictures within their borders to be shared with others..."beyond their borders." Particular emphasis will be given to photographs depicting where and how wireless is improving lives in the areas of health, education, creativity (entertainment/fun), environmental stewardship, safety, and advancement of world culture. Selected photos will be exhibited as part of the large-scale mobile phone digital installation at the Beyond the Border International Contemporary Art Fair held September 2-4, 2009 at the Grand Del Mar hotel in San Diego. Work will also be published in Qualcomm's global marketing materials and posted to the external Web site. All photo entries will be viewable on ReEnvisioning's Flickr page and can be accessed throught the Qualcomm Website: http://www-test.qualcomm.com/citizenship/community_involvement/reenvisio...

As part of Qualcomm's commitment to being a responsible corporate citizen, the Company supports the arts through art education and outreach programs encouraging young people to think creatively.

Beyond the Border International Contemporary Art Fair, San Diego is a 3-day contemporary art fair that will be held at The Grand Del Mar, San Diego's newest luxury resort in Coastal North San Diego County. The event is designed to attract international, national and regional art collectors. The Art of Living event, running simultaneously with the art fair at the resort, will spotlight the talents of the world's most promising winemakers and chefs, and feature exhibitors of luxury cars, watches and contemporary furniture among other luxury items. Sponsors include: the California Bipolar Foundation (VIP dinner with Dr. Kay Jamison September 4th), Maserati, Qualcomm, The Grand Del Mar and Modern Luxury Media.

Beyond the Border-Art, Inc., is producing the art fair, a strategic business-consulting firm comprised of leading professionals in the areas of event planning, marketing, development, art and architecture. BTB-Art, Inc is dedicated to establishing San Diego as the leading contemporary art fair destination on the West Coast.

For more information or to RSVP to any of the events, contact: Ann Berchtold, Executive Director Tel. 858.254.3031 Email aberchtold (at) beyondtheborder-art (dot) com BTB Website http://beyondtheborder-art.com

Francis Ford Coppola

By Kimberly Read & Marcia Purse, About.com
Francis Ford Coppola, born April 7, 1939, is a world renowned filmmaker. He is known for his work as a director, producer, composer, and writer. Coppola hails from a family very active in entertainment. His father, Carmine Coppola, attended Julliard and was a flautist in the NBC Symphony as well as a music arranger for the Ford Sunday Evening Hour on CBS radio (the source of Frances' middle name). Italia Pennino, Coppola's mother, also had been an actress. His younger sister, Talia Shire, is an actress with the roles of Adrian in Rocky and Connie Corleone in The Godfather Trilogy credited to her career. Nicolas Cage is his nephew. Coppola's interest in entertainment began quite young. Having contracted polio at age ten and suffering some paralysis, he was bedridden for almost a year. During that time, he watched a great deal of television, hosted puppet shows and toyed with film making using his father's 8 mm camera. Because he was a proficient tuba player, Coppola initially attended the New York Military Academy at Cornwallon-Hudson. However, he did not like this school and returned to public high school where his interest in play writing began. His competence as a young playwright gained him a scholarship to Hofstra University where he received his BA in Theater Arts. He later completed a Masters degree from the UCLA film school. Mr. Coppola has a number of incredibly stunning, successful movies to his credit. These include such classics as Patton, The Godfather Trilogy, The Conversation, and Apocalypse Now. The success of just these few movies garnered fourteen Academy Award nominations and five Oscars for Coppola. However, he has a much longer list of movies that were less than stellar in some cases and complete disasters in others. More than one biographical author has referred to Francis Coppola's career as Phoenix in nature. Wesley Morris entitled his article about Coppola's rework of Apocalypse Now as "The Phoenix" (Morris, 2002). The biography from Hollywood.com notes, "One of America's most erratic, energetic and controversial filmmakers, Francis Ford Coppola has enjoyed stunning triumphs and endured monumental setbacks, then resurrected himself, rising Phoenix-like to begin the process over again" (Matthew). Brilliant highs and cataclysmic lows ... this begs the question of bipolar disorder. Certainly every directory this author found of celebrities with bipolar disorder or mental illness listed Francis Ford Coppola. In a documentary of the making of Apocolypse Now, a movie that was beset with extreme difficulties and setbacks, Coppola's wife wrote, "I guess he has had a sort of nervous breakdown." Coppola himself noted, "little by little we went crazy," again, a reference to the difficulties of filming Apocolypse Now (Hollywood.com). However, other than remarks about this specific incident, there seems to be no written record of Francis Ford Coppola having been diagnosed with bipolar disorder. Regardless if Mr. Coppola has this disorder or not, in a rather detailed interview with Roger Ebert, Coppola is asked, "Does suffering enrich the artistic process?" His response is encouraging to all who strive to express their creativity, "Of course suffering or meeting difficulties that you don't know how to surmount causes you to try in ways you didn't think you could try, and by that, you know, stress and conflict does produce results that wouldn't have come if it were all easy" (Ebert, 2002).

Learning the Language of Bipolar Disorder

About.com
Thursday May 7, 2009
As with any special niche, the bipolar community has its own language, its own geek-speak for those who are in-the-know. In patient-centered communities, the bulk of this focuses on different medications and treatment options. You see people share things like, "I've been doing DBT for months" or "I take benzos to help me sleep." And we can't forget the interesting titles for all the various medical professionals. Among these titles there are also a couple of unique words found in mental health groups - words such as pdoc and tdoc. Pdoc is jargon or slang for psychiatrist. Some may also use this referencing their psychologist. You will frequently see this term used in online communities such as our forums and chat rooms. You may also hear it used in patient group settings such as hospitals or therapy. Pdoc is a compressed phrase combining psychiatrist/psychologist and doctor. In conversations patients often want to distinguish between their general practitioner and their mental health practitioner, but psychiatrist is a long word and difficult to spell. So, in keeping with the instant message/texting trends to rely on abbreviations and anagrams, we have the evolution of a new word - pdoc. The evolution of tdoc is pretty much the same. It combines therapist and doctor. However, in that the originating word therapist describes many different professionals - psychologists, counselors, pastors, social workers, life coaches, etc. - tdoc is interpreted just as widely. ~Kimberly

Shining a light on children

bp Magazine
As mentioned in the previous issue of Hope & Harmony, May is Mental Health Month, making it the ideal time to increase understanding and awareness of mental health issues. In this issue, we at bp Magazine and bp Canada would like to focus on children's and adolescents' mental health.

It's no surprise that mental health problems can be especially painful for young people. They can damage self-esteem, produce feelings of guilt and shame, and make children feel lonely and isolated.

But there are things adults can do to nurture the emotional well-being of the children in their lives. The U.S. Department of Health and Human Services recommends taking the following steps:

• Learn more about mental well-being in children.
• Celebrate their strengths and accomplishments.
• Foster their self-worth and independence.
• Help them express their feelings.
• Promote mutual respect and trust.
• Recognize their strengths.
• Appreciate each child's uniqueness.
• Encourage individual talents.
• Help children set goals based on their abilities and interests.
• Show confidence in their ability to handle problems and tackle new experiences.
• It's often said that it takes a village to raise a child. These tips serve as great reminders of the important role everyone can take in that process.

To learn more about children's mental health issues, we invite you to read two stories from past issues of bp and esperanza that highlight the struggles families face when a child is diagnosed with bipolar disorder, anxiety or depression.

Teenager with Bipolar Disorder?

This is a note from Julie Fast on teenagers and bipolar disorder treatment.

If you have a teenager with bipolar disorder, I'd love to know any questions you may have regarding their bipolar disorder treatment. I'm working on a new project for parents and want to make sure I cover all of the areas parents find confusing.

Here are some guidelines:

• Your teenager started symptoms in the teen years and not earlier. This is a project regarding teenage onset bipolar- Childhood onset before age 13 is quite different.
• Your teen has been professionally diagnosed with bipolar disorder- whether they accept the diagnosis or not!

My goal is helps parents work together and then ultimately with their teens on a treatment plan for bipolar disorder that works. My first manic episode was at 17, so I know what teens go through. Their needs are so different from adults- and as parents, the stress of helping a teen can be enormous.

Please feel free to send me any ideas of what information you think needs to be in a project for parents of teenagers with bipolar disorder, any questions you may have as well as any suggestions for others. If you have a success story, please send that along as well!

If you are a teen with bipolar disorder, I would love to hear your questions and comments as well. How can your parents help you? What do you need from them?

I will not be able to answer questions or comments personally due to the volume of mail I receive- but I will read every one and anonymously add the information to my project.

All people who participate in this project will be entered into a contest to win a set of my books and one of the first copies of the Parents Project.

Your help is invaluable. My goal is to create a system that saves families and teens from years of frustration and hardship. Teens can get better, go to school, have relationships and do the work and art they love! I want to make this happen- and need your help to do this in the right way.

If you would like to send your ideas, please reply to this email with 'teenager' in the subject line. I so look forward to reading your ideas and questions. Please add your name and address if you would like to be entered in the contest. You will receive a thank you email with more contest information. comments@bipolarhappens.com

Please note, I never use, sell or distribute your private information.

Thanks so much for your support. It keeps me going so that I can help others keep going!
Julie Fast
P.O. Box 86728 Portland, OR 97286 US

My Life as a Bipolar Mom

Cristina Fender, 34, of Austin, Texas, is an aspiring writer, blogger, and mother of two who was diagnosed with bipolar disorder in 2006. Each and every day Cristina struggles to manage her condition while taking care of her family. Though Cristina's approach to treating bipolar disorder isn't for everyone, her story vividly demonstrates how elusive stability can be for people with bipolar. more... http://www.health.com/health/condition-article/0,,20274523,00.html

Andy Behrman & His Adventures in the Drug Trade

Dear Friends,
Three years ago, after working as a spokesman for Abilify, a hugely profitable drug manufactured by Bristol Myers Squibb, I published an online article about the drug's terrible side effects. I said it was the worst drug that I had ever been prescribed and that it had nearly killed me.

Within twenty minutes of the article being posted on a website owned by the New York Times, the article came down. Turns out, BMS was a sponsor of the website.

Today I am preparing to sell a new book, Adventures in the Drug Trade, which details my nightmarish experience with Abilify, my treatment by Dr. Mark Frye, a former UCLA psychopharmacologist now at the Mayo Clinic and curiously no longer a medical consultant for BMS, and my experiences as a pusher of their not-so-wondrous wonder drug.
I believe that BMS will go to almost any lengths to stop me and the publication of the book. It's time to hold drug makers like BMS accountable for their corrupt practices and harmful products. Just as culpable, if not more so, are the licensed physicians that aid and abet them. Do no harm? I don't think so.

Today, The Wall Street Journal published a front page story about my experience titled, "A Celebrity Patient's Backing Turns Sour for Drug Company." I urge you to click here for an informative sixty second video: http://www.youtube.com/watch?v=9VzMZX4nBz8

This youtube link will give you more information about the dangers of Abilify. And then forward the link to everyone you know.

The sad reality is that the drug companies won't tell you the truth about the side effects of their drugs and for that matter, neither will your doctor. Did you know that pharmaceutical companies actually send some of these doctors on an all-expense-paid ten-day Caribbean cruises just for "writing prescriptions?"

I urge you to forward this e-mail to ten friends, family members and mental health care professionals, whose lives are affected by Big Pharma every day and who might be interested in hearing the truth.

If you're one of the 3,000+ mental health support groups around the country receiving this e-mail, I urge you to pass this on to your entire mailing list - - everyone should see the youtube video about the dangers of Abilify:

http://www.youtube.com/watch?v=9VzMZX4nBz8

We can beat big Pharma and their lies - - and even save some lives in the process -- but it has to begin with everyone standing up and telling the truth to anyone who will listen.

Thanks,
Andy Behrman
http://www.electroboy.com

Ask a Doctor

If any of your bipolar support group members would like to ask a doctor any medical questions about bipolar, have them check out:

http://www.physiciansforpatients.com (main website which includes links to all condition topics, doctor credentials, and website background, etc.)

The link from the main website to the bipolar site is: http://bipolar.physiciansforpatients.com

Physicians for Patients is a physician enhanced online support community. A physician is dedicated to each site to help guide discussions and answer questions. This resource will enable people to share information and obtain alternative opinions.

Brian Gondos, MD
Bipolar Physician
Specialty: Psychiatry
Education: Harvard University - Psychiatry Residency, Massachusetts General Hospital/McLean Hospital Adult Psychiatry Training Program

Dr. Gondos is dedicated to the Bipolar site. He is board certified and trained in Psychiatry at Harvard University and Massachusetts General Hospital/McLean Hospital.

If you think any of the people in your group might benefit from Physicians for Patients, please consider letting your members became aware of this resource. The site is just getting started so there are not a lot of members on yet, but Dr. Gondos is there and ready to answer questions.

Please consider signing up as a member.

Thank you,

Christina
PhysiciansforPatients.com Supporter and Advocate

Approval of Lamictal

Eurand Announces FDA Approval Of EUR-1048 (Lamictal(R) ODTTM), Co-Developed With GlaxoSmithKline
http://www.medicalnewstoday.com/articles/149614.php
Eurand N.V. (NASDAQ: EURX), a specialty pharmaceutical company that develops enhanced pharmaceutical and biopharmaceutical products based on its proprietary pharmaceutical technologies, announced that the U.

Bipolar Disorder - Eurand Announces FDA Approval Of EUR-1048 (Lamictal(R) ODT(TM)), Co-Developed With GlaxoSmithKline
http://www.medicalnewstoday.com/articles/149598.php
Eurand N.V. (NASDAQ: EURX), a specialty pharmaceutical company that develops enhanced pharmaceutical and biopharmaceutical products based on its proprietary pharmaceutical technologies, announced that the U.

Camp Rise Above

Camp Rise Above is a specialized summer camp for children with Bi-Polar disorder. This camp is a small group environment where every child gets personalized attention and his or her needs and interests are met. The focus of our camp is for kids to have a successful camp experience through fun and exciting activities and field trips. With enthusiasm and energy our counselors are able to complete our mission of having children naturally build friendships with one another. Our counselors have many years of mentoring, teaching and school experience working with kids and their individual needs. Our staff has also gone through training with Mary Ann McDonnell, APRN, BC, CEO and Cofounder of Step up for Kids, Inc and owner of South Shore Psychiatric Services, Inc. focusing on children with bi-polar disorder, and Kathy Regan, RN, nurse manager of the inpatient child psychiatry unit at Cambridge Hospital, Cambridge, MA and author of "Opening Our Arms: Helping Troubled Kids".

Camp Structure: campers will gather each morning to discuss the day's coming events, expectations, and social themes and then depart on their activity for that day. The end of each day will include a discussion of occurrences, areas of improvement, and commendation for those who excelled in designated areas.

Field Trips of the two week camp include:
Frisbee Golf @ Balboa Park
Birch Aquarium
Sailing
Karate Group Class
Water Parks
Nickel City

Themes of this session include:
Enhancing positive thought patterns
Mastering Fear
Self Esteem
Controlling emotions

Drop Off Location: San Dieguito Park in Solana Beach. Exit Lomas Santa Fe Drive, head East and turn left at the four way stop sign. The park is on the right.Registration deadline is May 20th.

Highlights

• Boys and Girls ages 8 -12
• Camp hours: 10:45am - 3:45pm
• 2 Kids to 1 Staff Ratio
• Small Group environment. Max 10 kids
• Specifically trained and energetic counselors / mentors
• Achievement plans
• Performance tracking

Camp Dates:
July 20th - 24th
August 17th - 21st

Pricing (All inclusive) $625 per week. (Scholarships are available)
To sign up contact John Foletta
jfoletta@exciteway.com
Phone: 858-922-5920

The World's Most Influential People

In the annual TIME 100 issue, we do the impossible: name the people who most affect our world; DAVID SHEFF
David Sheff
By Dr. Nora Volkow

David Sheff wrote a beautiful book called, appropriately enough, Beautiful Boy - A Father's Journey Through His Son's Meth Addiction, one of the most compelling portrayals I've ever read of a parent's loss of a child to drugs. In this journey, Sheff, 53, faces the overdose of his son Nic and his inability to protect him, the relapses that inevitably occur and the family's struggle to cope with it all. Many people still call addiction a moral failing. But 20 years of research tells us that it's a disease that results in part from the damage that abused drugs do to the brain circuits required for self-control. Unfortunately that damage is long-lasting, meaning that the person remains vulnerable to relapse even after years of successful rehabilitation.

Sheff's experiences highlight how poorly our society addresses addiction. We treat the medical consequences of the problem (overdoses, car accidents, cancer, HIV, mental illnesses) but not the disease itself. Our investments in research and services for addiction treatment are a fraction of the costs associated with drug-related incarceration and lost productivity. Yet punishment and stigmatization do nothing to ameliorate the problem. How could they, when about 50% of addiction is rooted in our genes and much of the rest is due to social and cultural factors such as stressful childhood experiences?

Nic Sheff is alive today thanks in great measure to the devotion and resourcefulness of his extraordinary family. But many others have not been so fortunate. David Sheff's voice resonates loudly and makes us pause and ask why, despite our understanding of addiction as a brain disease, we fail to treat it as we do other medical illnesses.
Volkow is the director of the National Institute on Drug Abuse

A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD

Landen M et al. - The fact that bipolar patients with a history of childhood ADHD have a different clinical outcome than the pure bipolar group, regardless of whether the ADHD symptoms remained in adulthood or not, suggests that it represent a distinct early-onset phenotype of bipolar disorder. http://www3.interscience.wiley.com/journal/122376244/abstract?CRETRY=1&S...

Ultra-brief pulse ECT in bipolar and unipolar depressive disorder: differences in speed of response

Bipolar Disorders, 05/13/09
Sienaert P et al. - Patients with bipolar depression tend to show more rapid clinical improvement with ECT than patients with unipolar depression.
Methods: All patients (n = 64) participated in a randomized trial comparing ultra-brief pulse bifrontal ECT at 1.5 times seizure threshold and unilateral ECT at 6 times seizure threshold.
Thirteen patients (20.3%) had DSM-IV-defined bipolar depression.
The Hamilton Rating Scale for Depression and Clinical Global Impression scale were administered at baseline and repeated weekly during and after the course of treatment by a blinded rater.
At the same time point, the Beck Depression Inventory and the Patient Global Impression scale were administered.
Speed of response was analyzed using survival analyses.
Results: Patients with bipolar and unipolar depression did not differ in rates of response or remission following the ECT course, nor in response to unilateral or bifrontal ECT.
Patients with bipolar depression, however, showed a more rapid response than patients with unipolar depression.

Earliest symptoms discriminating illness from ADHD

Bipolar Disorders, 05/14/09
Elevated mood and decreased sleep discriminated JO-BP and ADHD as early as age 3, while classic ADHD symptoms were parallel in the groups. These retrospective results provide preliminary insights into symptom differences and their temporal evolution between bipolar disorder and ADHD in the first 10 years of life. service fetr

Methods: Parents of formally diagnosed children retrospectively rated 37 symptoms in each year of the child's life based on the degree of dysfunction in their child's usual family, social, or educational roles.

A subset of children with onset of bipolar disorder prior to age 9 (JO-BP) compared with those with ADHD was the focus of this analysis.

Results: Brief and extended periods of mood elevation and decreased sleep were strong early differentiators of JO-BP and ADHD children.

Depressive and somatic symptoms were later differentiators. Irritability and poor frustration tolerance differentiated the two groups only in their greater incidence and severity in JO-BP compared with a moderate occurrence in ADHD. In contrast, hyperactivity, impulsivity, and decreased attention showed highly similar trajectories in the two groups.

Cardiovascular risk in patients with bipolar disorder

Journal of Affective Disorders, 05/15/09
Garcia-Portilla MP et al. - Cardiovascular risk is high in patients with bipolar disorder. It is associated with age, body mass index and metabolic syndrome. Psychiatrists should be aware of this issue and carefully monitor these patients for cardiovascular risk factors, including cigarette smoking, as part of the standard of care when treating them.

Methods: Naturalistic, cross-sectional, multicenter study conducted in Spain.
Patients were evaluated for cardiovascular risk using the Framinghan function (CHD) and the Systematic COronary Risk Evaluation (SCORE) function (CMR).

Results: The mean age was 46.6 years and 49% were male.
Forty-six percent were in remission.
Ten-year CHD risk was 7.6% (males 10.2% versus females 4.7%, p < 0.001) and 10-year CMR was 1.8% (males 2.2% versus females 1.3%, p 0.161).
Fifty-one percent smoked and 34% was obese.
Metabolic syndrome was present in 22.4% of the sample (35.6% according to AHA and NHLBI criteria).
Cardiovascular risk significantly increases with age, body mass index and presence of metabolic syndrome.

Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions

Bolton, J. et al Abstract
Background: Using alcohol or drugs to reduce emotional distress (self-medication) has been proposed as an explanation for the high comorbidity rates between anxiety and substance use disorders. Self-medication has been minimally studied in mood disorders despite equally high rates of alcohol and drug use.

Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (n = 43,093, age 18 years and older) nationally representative survey of mental illness in community-dwelling adults. Prevalence rates of self-medication were determined for DSM-IV mood disorders: dysthymia, major depressive disorder, bipolar I disorder, and bipolar II disorder. Multiple logistic regression generated odds ratios for the association between each category of self-medication and anxiety and personality disorders.
Results: Almost one-quarter of individuals with mood disorders (24.1%) used alcohol or drugs to relieve symptoms. The highest prevalence of self-medication was seen in bipolar I disorder (41.0%). Men were more than twice as likely as women to engage in self-medication (Adjusted Odds Ratio = 2.18; 95% Confidence Interval 1.90-2.49). After controlling for the effects of substance use disorders, self-medication was associated with higher odds of comorbid anxiety and personality disorders when compared to individuals who did not self-medicate.
Limitations: Cross-sectional design.
Conclusions: The use of alcohol and drugs to relieve affective symptoms is common among individuals with mood disorders in the general population, yet is associated with substantial psychiatric comorbidity. These findings may help clinicians identify a subgroup of people with mood disorders who suffer from a higher mental illness burden.
Journal of Affective Disorders
Volume 115, Issue 3, June 2009, Pages 367-375

Neurocognitive Dysfunction in Bipolar and Schizophrenia Spectrum Disorders Depends on History of Psychosis Rather Than Diagnostic Group

Schizophrenia Bulletin, 05/19/09
Simonsen C et al. - This study suggests that neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders is determined more by history of psychosis than by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnostic category or subtype, supporting a more dimensional approach in future diagnostic systems.

Methods: A sample of individuals with schizophrenia (n = 102), schizoaffective disorder (n = 27), and bipolar disorder (I or II) with history of psychosis (n = 75) and without history of psychosis (n = 61) and healthy controls (n = 280), from a large ongoing study on severe mental disorder, were included. Neurocognitive function was measured with a comprehensive neuropsychological test battery.

Results: Compared with controls, all 3 groups with a history of psychosis performed poorer across neurocognitive measures, while the bipolar group without a history of psychosis was only impaired on a measure of processing speed.
The groups with a history of psychosis did not differ from each other but performed poorer than the group without a history of psychosis on a number of neurocognitive measures. These neurocognitive group differences were of a magnitude expected to have clinical significance. In the bipolar sample, history of psychosis explained more of the neurocognitive variance than bipolar diagnostic subtype.

Four-Year Longitudinal Course of Children and Adolescents With Bipolar Spectrum Disorders: The Course and Outcome of Bipolar Youth (COBY) Study

American Journal of Psychiatry, 05/21/09

Birmaher B et al. - Bipolar spectrum disorders in youths are characterized by episodic illness with subsyndromal and, less frequently, syndromal episodes with mainly depressive and mixed symptoms and rapid mood changes.

Methods: At total of 413 youths (ages 7-17 years) with bipolar I disorder (N=244), bipolar II disorder (N=28), and bipolar disorder not otherwise specified (N=141) were enrolled in the study. Symptoms were ascertained retrospectively on average every 9.4 months for 4 years using the Longitudinal Interval Follow-Up Evaluation. Rates and time to recovery and recurrence and week-by-week symptomatic status were analyzed.

Results: Approximately 2.5 years after onset of their index episode, 81.5% of the participants had fully recovered, but 1.5 years later 62.5% had a syndromal recurrence, particularly depression. One-third of the participants had one syndromal recurrence, and 30% had two or more. The polarity of the index episode predicted that of subsequent episodes. Participants were symptomatic during 60% of the follow-up period, particularly with subsyndromal symptoms of depression and mixed polarity, with numerous changes in mood polarity. Manic symptomatology, especially syndromal, was less frequent, and bipolar II was mainly manifested by depressive symptoms.

Overall, 40% of the participants had syndromal or subsyndromal symptoms during 75% of the follow-up period, and 16% of the participants experienced psychotic symptoms during 17% the follow-up period. Twenty-five percent of youths with bipolar II converted to bipolar I, and 38% of those with bipolar disorder not otherwise specified converted to bipolar I or II.
Early onset, diagnosis of bipolar disorder not otherwise specified, long illness duration, low socioeconomic status, and family history of mood disorders were associated with poorer outcomes.

New Genes for Bipolar Disorder

Researchers have used a gene chip to identify SNPs associated with bipolar disorder in American, British, and Irish patients. They identified two genes, both involved in ion channels. Nick Craddock, who led the Nature Genetics study, told the New York Times that the genes are probably only involved in a few bipolar cases and with modest effect. He adds, however, that identifying involved genes will help elucidate the pathways involved in bipolar disorder.

Drugs Being Studied for Bipolar Disorder in Older Adults

By Psych Central News Editor
Reviewed by John M. Grohol, Psy.D. on May 8, 2009
New research is being conducted to examine two drugs' effectiveness in the treatment of bipolar disorder in older adults.

The study will examine the effectiveness and adverse effects of quetiapine (Seroquel) and lamotrigine (Lamictal) in older adults. Older adults are often prescribed these medications, but few large-scale studies have been conducted to examine the implications of such prescriptions. The studies are being led by Robert C. Young, professor of psychiatry at Weill Cornell Medical College, and his colleagues at the Institute of Geriatric Psychiatry.

"To date, most bipolar disorder treatment studies have been conducted in younger patients," noted Young. "In some older bipolar patients a good symptom response is difficult to achieve, and they often have recurring symptoms, disability, multiple medical disorders and increased mortality rates. We hope that findings from these studies will help physicians better manage the care of their geriatric bipolar patients."

Eligible participants must be 60 years of age or older with a diagnosis of bipolar disorder and currently suffering from symptoms of depression. They will be required to meet with a psychiatrist one day per week for a few hours and receive medication management from the treatment team.

Dr. Young and his colleagues are also continuing to lead another study, funded by the National Institute of Mental Health (NIMH) and now in its fourth year, comparing the efficacy of two commonly used mood stabilizers, lithium and valproate, for the treatment of bipolar disorder in older adults.

"We've heard from some participants in the NIMH study that they have gotten satisfaction in knowing that the findings from this important research may be of benefit to other older individuals - now and in the years ahead - who are similarly afflicted with bipolar disorder."
Bipolar disorder involves periods of elevated mood - mania or hypomania - and periods of depression, or "mixed" episodes in which patients have both kinds of symptoms. Examples of manic symptoms are high levels of energy, going without sleep for extended periods, elated mood or irritability, and impulsive or reckless behavior. Patients may not recognize that they are having symptoms.

The studies are funded by AstraZeneca and GlaxoSmithKline, makers of the two medications being studied. Dr. Young has received an honorarium for a talk sponsored by AstraZeneca. The research is being conducted at the Weill Cornell Institute of Geriatric Psychiatry at the New York - Presbyterian Hospital / Westchester Division in White Plains, New York.
Source: New York - Presbyterian Hospital

Glenn Close's sister has BPD

PORTLAND (NEWS CENTER) -- Actress Glenn Close made an appearance in Portland this weekend, serving as the emcee for a walk benefitting the Maine chapter of NAMI, the National Alliance on Mental Illness.

Close has made it her mission to help reduce the stigma that goes along with mental illness because her sister is bipolar, and her nephew has schizophrenia.
The NAMI walk tries to put a face on mental illness, and it's also the organization's major fundraiser. This year's walk has raised $100,000.

Close, who's also putting together a national ad campaign and website to help families dealing with mental illness, said she feels strongly that these efforts do make a difference. Close said, "Even in mounting this campaign and talking about it and talking about it with my sister, I feel a great feeling of release. Because I believe we will be able to very soon be able to say schizophrenia, bipolar, depression and... it will be like cancer and diabetes and it won't have that stigma."

Close also is auctioning off a walk-on role in her TV series "Damages" to benefit NAMI Maine.

Optimism For Bipolar Disorder And Schizophrenia If Psychiatrists Abandon 19th Century Dogma, UK

Nineteenth century thinking about schizophrenia and bipolar disorder must be abandoned if psychiatry is to progress, said a leading UK psychiatrist. At a meeting of the Biochemical Society, Professor Nick Craddock from Cardiff University urged his profession to embrace the opportunities offered by new research methodologies.

Advanced technology and the large sample sizes in research have led to unprecedented advances in the identification of specific genetic risk factors for psychiatric disorders as recently as the last two years. "For more than 100 years there has been a widespread assumption that bipolar disorder (manic depression) and schizophrenia are completely separate diseases. Recent evidence, particularly from molecular genetics, shows the situation is not so simple. Some of the susceptibility genes are shared," he said.

Strong genetic associations have been reported in bipolar disorder and schizophrenia. Emerging data provide a powerful resource for exploring the relationship between psychiatric characteristics. "This new knowledge will help to explain why some people receive a diagnosis of schizophrenia at one time and bipolar disorder at another time and why some receive a mixed diagnosis - so called 'schizoaffective' disorder," he said.

It is already clear that, in general, genetic associations are not specific to one of the traditional diagnostic categories. For example, one gene variation (ZNF804A) is associated with risk of both bipolar disorder and schizophrenia, and some rare 'copy number' variations are associated with the risk of autism and epilepsy as well as schizophrenia. "There is an urgent need to think beyond diagnostic "boxes" and consider how variations in brain biology and function lead to the huge range of clinical variations seen in people with psychiatric diseases," said Professor Craddock.

Whilst many family and twin studies have demonstrated the importance of genetic factors influencing susceptibility to bipolar disorder, only recently have research technologies started to identify these risk factors. It is, according to Professor Craddock, a successful start to a long journey.

"We know that there are many genes involved in bipolar disorder. Two such genes have been strongly implicated in recent studies of over 10,000 individuals," he said. The action of both genes is thought to be through effects on the basic control of the excitability of nerve cells. Although not of immediate clinical use, this new understanding will open up new avenues for research and should ultimately lead to improved treatments.

Professor Craddock concluded, "This is a time of rapid progress in bipolar disorder research. Those with illness can be optimistic for the next generation."

FDA approves dissolvable version of Lamictal

The U.S. Food and Drug Administration has approved a dissolvable version of GlaxoSmithKline PLC's blockbuster drug Lamictal, the company said Monday.
Lamictal, or lamotrigine, is prescribed for the treatment of epilepsy or bipolar disorders. The company said a dissolvable version, which disintegrates on the patient's tongue, is important because people with those disorders can have a hard time swallowing pills

Tips for getting insurance when you have a pre-existing condition

by Elizabeth Cohen (CNN)
Nineteen year-old Stuart Wald is not likely to grow out of his schizophrenia, bipolar disease and attention deficit disorder. But he will, with 100 percent certainty, grow out of the health insurance coverage he has through his father's employer http://www.cnn.com/2009/HEALTH/05/14/preexisting.condition.insurance/ind...

New Drugs Have Allure, Not Track Record

By RICHARD A. FRIEDMAN, M.D.
Published: May 18, 2009
Recently, one of my residents told me about a patient with bipolar disorder whose psychiatrist had prescribed an exotic cocktail of drugs - a sedative, a new mood stabilizer and the latest antipsychotic medication. I was puzzled - not by her case, which the resident described as textbook manic depression, but by what was left out. This patient, it seems, was never offered lithium, the single most effective treatment for bipolar disorder.

When I met with my residents in their weekly seminar, I decided to make a big deal of this case. "What do you think about her treatment?" I asked them. There was a long silence. "What's wrong with it?" one resident replied. Finally, a resident offered that he knew the right answer was lithium, but that newer treatments were more popular.

Now I got it. Never mind that lithium has proved its safety and efficacy over decades of use; it's passé - eclipsed by all the new and sexy blockbuster drugs. Lithium salts have been used to counter bipolar disorder since the 1950s, when it was discovered that they greatly reduced the intensity and frequency of mood swings in about 70 percent of patients with the disorder. While lithium must be taken with care - it is therapeutic in a narrow range of blood levels, and overdoses can be toxic - it is also the only psychotropic drug that has ever been shown to have specific antisuicidal effects. That makes it especially valuable, given the high risk of suicide associated with mood disorders.

But lithium is cheap and unpatented, so drug companies have little interest in it. Instead, they have made a new generation of mood stabilizers, some more tolerable than lithium, but none more effective. And lithium is hardly the only unsexy but effective drug to fall by the wayside. New medical treatments are a bit like the proverbial new kid on the block: they have an allure that is hard to resist.

Doctors and patients alike are inundated by drug company marketing. The companies like to say they are interested in educating the public and physicians about various illnesses, though I have yet to meet a single patient who learned anything informative about any disease from an advertisement. Instead, I have seen scores of patients in my office, eager to get the latest antidepressant or mood stabilizer that promised them tranquility on their TV screens.
No wonder: drug company spending on consumer advertising skyrocketed 330 percent from 1996 to 2005, according to a 2007 study in The New England Journal of Medicine.
Unlike the public, physicians continue to believe that they are immune to the influence of drug companies, despite strong evidence to the contrary. Studies have shown that doctors with ties to industry are more likely to prescribe a brand-name drug over a cheaper generic version than doctors without such ties.

This is not to say that all influence is bad. If a new drug actually proves to be safer or more effective than its predecessors, then of course it should be prescribed for those whom it will benefit.

All too often, though, the new panacea is nothing more than a "me too" drug - a minor modification of an available drug, offering little or no advantage in safety or efficacy.
Not long ago I saw a patient who told me she had treatment-resistant depression. She had failed to respond to multiple trials of five new antidepressants, including two from the same class of drugs. I called her psychiatrist, a smart young doctor whom I know, to ask if she had ever been given one of the older antidepressants, like a tricylic or a MAOI (for monoamine oxidase inhibitor). He had little experience with these highly effective older drugs, so he hadn't thought to use them.

I suggested that she try an MAOI. After six weeks, she improved remarkably.
Now it's true that the newer antidepressants are generally safer and more tolerable than older ones, which is an important advantage, but they are no more effective than older antidepressants.

My younger colleague had been trained recently and had tremendous knowledge about the latest research and drugs. But his training failed to provide him with the larger context in which to place all these exciting developments.

Specifically, how do all these new drugs stack up against older ones? That is not something that we know enough about. And it is not something drug companies have any interest in discovering. To earn approval from the Food and Drug Administration, a new drug just has to beat a placebo, not a standard drug, in two clinical trials.

But patients and doctors need to know not just whether a new drug outperforms a placebo, but whether it's a real advance on what is already on the market. For that, we need head-to-head trials comparing new and standard treatments.

That is precisely the goal of comparative-effectiveness research, President Obama's ambitious initiative to help determine which treatments really work. As you might expect, it has provoked strong resistance from the makers of drugs and devices who fear that their fancy new products may not be any better than current ones.

I don't know about you, but I'd opt for an old drug with a known track record of efficacy and safety over an expensive newcomer with no added benefit - any day of the week.
Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.

Patient Voices: Bipolar Disorder

What is it like to have bipolar disorder? To be labeled "crazy"? How do you balance the ups and downs? Here, in their own words, are the stories of nine men and women living with bipolar disorder.
Go to this site for audio: http://www.nytimes.com/interactive/2008/07/16/health/healthguide/TE_BIPO...

Stone Temple Pilots singer finds comfort in hymn

DOUG ELFMAN:
You never know how life will turn out for a little boy. Scott Weiland is the idolized singer for Stone Temple Pilots and the ex-singer of Velvet Revolver -- yet he was tripped up by bipolar disorder, heroin (he's in recovery) and arrests. When he was small, Weiland was an altar boy. He went to church every Sunday and loved singing the hymn "Be Not Afraid" with his mom.

"The hair used to stand up on the back of your neck," Weiland tells me, "and my mom would hold my hand, and I would always see tears go down her face when she'd sing."
And they sang, "If you stand before the power of hell/ and death is at your side/ know that I am with you, through it all/ Be not afraid."

Weiland's younger brother Michael was by their side. But Michael's journey ended in tragedy. Two years ago, as Weiland has put it, Michael couldn't see his kids because of a restraining order, he gave up on everything and overdosed, dying with a broken heart.

The mother of these two brothers asked Weiland to play a recording of "Be Not Afraid" at Michael's funeral. "Mom, I think we can one-up that," he told her. He wanted to record the hymn with co-writer Doug Grean. "No, honey," his mom said. "I don't want you to put yourself out on this right now, not after everything we're all going through."

But Weiland -- who takes his son to church on high holidays -- found the song a positive comfort on which to focus. "Doug and I," he says, "performed it at my brother's ceremony in front of all the friends and family. "To get through that song at the Los Angeles Cathedral was nearly impossible without choking up on tears. "I miss him every day."

RECOVERY
Weiland did coke at some point in 2007, but he's stayed off heroin for four years.
"Yeah, things are going really good, actually," concerning his recovery. He found inspiration in reading the story of Bill W., co-founder of Alcoholics Anonymous, but also in reading (while in "drug jail") Hermann Hesse's classic "Siddhartha."

"It kind of changed my way of looking at things," he says. Siddhartha quests for peace and enlightenment through a long life of lust, fortune and loss. As Weiland, 41, says, Siddhartha realizes attaining goals isn't the same as joy. "Ultimately, that's not happiness," Weiland says. "He ends up finding it out in the end, and remembering that he heard it early on: that happiness is not reaching that destination; it's the journey."
STP HAS 18 NEW SONGS

Bipolar patients often relapse: study

NEW YORK (Reuters Health) - Results of a study suggest that bipolar disorder has a high relapse rate. In the study, researchers found evidence that three fourths of the hospitalizations for treatment of bipolar disorder are repeat admissions.

The study findings were reported today at the American Psychiatric Association's annual meeting in San Francisco.

Bipolar disorder, also known as manic depression, typically causes wide swings in mood -- sometimes from extreme incapacitating depression to euphoric recklessness.

"It is well known that bipolar disorder is a recurrent disease, so we considered it important to assess hospitalization patterns as an indication of the course of illness," principal investigator Dr. Urban sby from Danderyd University Hospital, Sweden, told Reuters Health prior to his presentation.

Despite an overall drop in the number of psychiatric hospitalizations in Sweden, their findings showed that the rate of admissions for treatment of bipolar disorder remained steady between 1997 and 2005, the psychiatrist noted.

Furthermore, he said, "When we followed up a cohort of all patients with their first bipolar disorder admission in the year 2000 for 5 years, 60% had no readmissions, and 15% of the patients had 66 of the readmissions."

The average readmission rate per patient during those 5 years was 1.2 following a first hospitalization; the rate was higher at 1.9 per patient following a second admission.
Roughly half the hospital admissions were for manic episodes and one quarter were for depression; the remainder was diagnosed as mixed episodes and "unspecified/other."
These findings, the investigators conclude, support that bipolar disorder has a high relapse rate.

Alkermes drug wins second FDA approval

Boston Business Journal - by Julie M. Donnelly
Drug maker Alkermes Inc. said one of its products, a therapy for schizophrenia, has received an additional approval from the U.S. Food and Drug Administration to be used for the treatment of bipolar disorder.

RISPERDAL CONSTA , which is sold by Johnson & Johnson (NYSE: JJ) is the first long-acting injection approved for either disease, and offers an alternative to patients who do not adhere to a daily medication regimen. The drug is administered in a doctor's office once every two weeks.

"The challenge is that if patients don't take their medication every day, they are at risk for relapse. These patients could benefit from treatment by injection," Alkermes CEO David Broeker said.

RISPERDAL CONSTA was approved in 2003 as an atypical anti-psychotic agent for the treatment of schizophrenia. Sales of the drug were $1.3 billion worldwide in 2008. Alkermes (NASDAQ: ALKS) is expected to receive 7 percent to 7.5 percent of the drug's sales proceeds in royalties.

Proteins Implicated in Brain Disease

By Rick Nauert, Ph.D. Senior News Editor
Reviewed by John M. Grohol, Psy.D. on May 21, 2009
Scientists have discovered a set of brain proteins responsible for some of the most common and devastating brain diseases.

The proteins underlie epilepsy, depression, schizophrenia, bipolar disease, mental retardation and neurodegenerative diseases including Alzheimer's and Huntington's diseases.

"The reason such a remarkable number of diseases are relevant to this set of proteins is that these proteins are at the heart of how brain cells function," explains Professor Seth Grant, Director of the Genes to Cognition Programme at the Wellcome Trust Sanger Institute.
Rather than taking traditional methods for studying just one protein at a time, the researchers developed a method that finds whole sets of proteins that bind to each other and form microscopic molecular machines. They were hunting for the 'engine room' of nerve cells, which is known to be inside the connections between nerve cells called synapses.
Synapses join the billions of nerve cells together in the brain and they are the location where learning and memory and many other behaviours are controlled.

"We developed a new method, which led to this discovery," says Dr Jyoti Choudhary, leader of the Proteomic Mass Spectrometry team, which collaborated with Professor Grant's team on the study, "and it should be equally useful in finding the basis of many other diseases in other cells and tissues of the body."

To find this key set of proteins - called MASCs (a scientific acronym for MAGUK Associated Signaling Complexes and pronounced 'mask') - the researchers adapted a method that had previously been used in yeast cells.

The method involved making a 'molecular hook' and attaching it to one protein inside brain cells of mice. They then caught the hook and pulled it out and found it brought along another 100 proteins. The set contained dozens of disease causing proteins.
"This points to the new concept that the molecular machines are defective in the diseases and that they present new ways to approach therapy," says Dr Choudhary.
Not only were there many disease proteins within the molecular machines but also proteins that control the communication between nerve cells and the mechanisms of learning and memory.

"This research is an important convergence of basic and clinical science," says Professor Grant. "Our findings are exciting because they suggest that the molecular machine itself is at the root of many important brain diseases.
"This was a blue-skies research project seeking the basic mechanisms of learning and memory and it has led us into some of the inner workings of the brain."
"This is a key step toward new ways to fight mental illness."

Treatment and prevention of mania in bipolar I disorder: focus on aripiprazole

Neuropsychiatric Disease and Treatment, 05/21/09
Muzina DJ - Aripiprazole is a second-generation antipsychotic with a unique pharmacologic receptor profile that has efficacy in the treatment and prevention of mania in bipolar I disorder. This article reviews the evidence supporting treatment of adults with bipolar I disorder using aripiprazole as monotherapy or adjunctively during acute mania and its utility as an intramuscular agent for agitation in manic patients. Results from one of the longest bipolar maintenance trials which support aripiprazole as a prophylactic mood stabilizer, specifically against manic relapses, will be discussed as well as a post-hoc analysis that suggests efficacy for rapid cycling bipolar disorder. Safety and tolerability issues, patient-focused perspectives and aripiprazole's place in therapy for bipolar mania will be covered.

A Genomewide Association Study of Response to Lithium for Prevention of Recurrence in Bipolar Disorder

American Journal of Psychiatry, 05/20/09
Perlis RH et al. - Multiple novel loci merit further examination for association with lithium response in bipolar disorder patients, including one region that spans the GRIA2 gene, for which expression has been shown to be regulated by lithium treatment.

Methods: The hazard for mood episode recurrence was examined among 1,177 patients with bipolar I disorder or bipolar II disorder, including 458 individuals treated with lithium carbonate or citrate, who were participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) cohort.

SNPs showing the greatest evidence of association in Cox regression models were then examined for association with positive lithium response among 359 bipolar I or II disorder patients treated with lithium carbonate or citrate in a second cohort from the University College London.

Results: The strongest association in the STEP-BD cohort (minimum p=5.5x10-7) was identified for a region on chromosome 10p15 (rs10795189).

Of the regions showing suggestive evidence (p<5x10-4) of association with lithium response, five were further associated with positive lithium response in the University College London cohort, including SNPs in a region on chromosome 4q32 spanning a gene coding for the glutamate/alpha-amino-3-hydroxy-5-methyl-4-isoxazolpropionate (AMPA) receptor GRIA2.

Pfizer Launches Free Medicines Program For Newly Unemployed Americans

Employees Inspire Plan to Help People Continue Pfizer Therapy During Unprecedented Economic Times

NEW YORK--(BUSINESS WIRE)--Pfizer Inc announced today that it will launch an innovative program to help eligible unemployed Americans and their families who have lost their health insurance maintain access to their Pfizer medicines for free. The inspiration for the new program, called MAINTAIN™ (Medicines Assistance for Those who Are in Need), was generated by Pfizer employees who were witnessing friends, family and neighbors struggle to make ends meet after losing their jobs.

"We all know people who have been laid off recently and have lost their health insurance, making it difficult for them to pay for health care," said Dr. Jorge Puente, Pfizer's regional president of Worldwide Pharmaceuticals, a leading champion of the initiative. "We thought there must be some way we could help recently unemployed people who are taking Pfizer medicines to continue treatment during these challenging economic times."

The program, which applies regardless of prior family income, will be open for enrollment through December 31, 2009 and applies to eligible Americans who have become unemployed since January 1, 2009. It is designed to help recently unemployed Americans and their families who have lost their insurance and who are taking Pfizer medicines to continue treatment for free for up to one year. Nearly 46 million Americans lack health insurance coverage, and that number is increasing as unemployment rates reach their highest levels in 25 years.

Pfizer employees proposed the idea of MAINTAIN to the company's senior leadership team just within the last month. Pfizer employees also asked to be able to do their part by donating their own money to the program, and the Pfizer Foundation will match their donations.

"The current economic environment has added considerable new stress to the daily life of millions of hard-working Americans, and our colleagues are responding to help their neighbors in the communities where they reside," said Jeffrey B. Kindler, chairman and chief executive officer of Pfizer. "The speed with which we created and approved this program is proof of our commitment to help people access the medicines they need to live healthier lives. With the launch of this initiative, which I am proud to say was proposed by our colleagues, we are doing what we can to ensure that recent loss of employment does not preclude people from managing their health."

Eligibility requirements of the new program include:

• Loss of employment since January 1, 2009
• Prescribed and taking a Pfizer medicine for at least 3 months prior to becoming unemployed and enrolling in the program
• Lack of prescription drug coverage
• Can attest to financial hardship

People who qualify will receive their Pfizer medicines for free for up to 12 months or until they become re-insured (whichever comes first). More than 70 Pfizer primary care medicines will be available through the program.

To make it easy for people to apply, the program will be integrated into Pfizer's existing family of patient assistance programs called Pfizer Helpful Answers®. A single point of entry makes it easy to get help:

All of Pfizer's patient assistance programs, including the new program, can be reached by calling a single phone number (1-866-706-2400) or by visiting www.PfizerHelpfulAnswers.com

Those who contact Pfizer Helpful Answers in need of medicines made by another company will be directed to the Partnership for Prescription Assistance, a pharmaceutical industry initiative that serves to raise awareness of, and boost enrollment in, more than 475 public and private patient assistance programs.

The new program will be fully operational on July 1, 2009. However, people in need now can call 1-866-706-2400 for help. MAINTAIN is a part of Pfizer Helpful Answers, a joint program of Pfizer Inc and the Pfizer Patient Assistance Foundation.Here is a list of other financial assistance programs. http://bipolar.about.com/od/financialassistance/Financial_Assistance.htm

Bipolar Disorder is not an automatic decline; Life Insurance

Know what it takes to Succeed:

• No hospitalizations other than for diagnosis
• No suicide attempts or bouts with suicidal ideations
• Compliant with treatment including medications and regular followups
• Stable family, social and/or work life
• Not on disability for bipolar
• No issues with drug or alcohol abuse

"It is like finding an oasis in the desert to find life insurance people who treat me as a person with name rather than as a liability with a risk analysis" - Marsha E.
866-539-7914 http://www.bipolarlifeinsurance.com/

Interview with Brian Yorkey - Writer and Lyricist of Next to Normal, A Musical About Bipolar Disorder

by Kimberly Read
One family is about to meet the music. Next to Normal opened in Spring 2009 on Broadway at the Booth Theatre in New York City, following its sold-out engagements at both New York City's Second Stage Theatre and Washington DC's Arena Stage. The tale of this musical deals with bipolar disorder from the perspective of a suburban household. The character Diana, played by Alice Ripley, is a mother careworn and struggling with bipolar disorder. Brian Yorkey is the writer and lyricist for the text and songs of this musical. I had the opportunity to ask Mr. Yorkey a few questions about this production. http://bipolar.about.com/od/mediaportrayals/a/brian_yorkey.htm?nl=1

Accommodations & Rights for College Students with Disabilities

Parents of kids with disabilities are often surprised to learn that their college-bound children are no longer eligible for services. IDEA does not follow a child into post-secondary programs. However, students do have rights and protections under Section 504 and ADA. http://www.wrightslaw.com/heath/college.waive.req.htm

Medication treatment perceptions, concerns and expectations among depressed individuals with Type I Bipolar Disorder

Journal of Affective Disorders, 05/18/09
Sajatovic M et al. - While individuals with BD appreciate the effects of medications, concerns regarding adverse effects and discrepancy between actual and hoped-for outcomes can be substantial. Subjective experience with medications using qualitative and quantitative methods should be explored in order to optimize treatment collaboration and outcomes.

Methods: Adults with Type I BD, mean age 36.6 years, 51% women, completed a semi-structured interview that was audio taped, transcribed, coded and analyzed along emergent themes. Quantitative scales measured depressive symptoms (Hamilton Depression Scale/HAM-D), psychopathology (Clinical Global Impression/CGI), and insight and treatment attitudes (Insight and Treatment Attitudes Questionnaire/ITAQ).

Results: Individuals had moderate depression and psychopathology with good insight into need for treatment. Drug treatment was perceived as beneficial, by "stabilizing" or "balancing" mood (42%, N = 38), decreasing anxiety/depressive symptoms (19%, N = 17) and improving sleep (10%, N = 9). While 39%, (N = 35) of individuals denied medication concerns, nearly 29%, (N = 26) feared possible long-term effects, particularly diabetes or liver/kidney damage. Media stories and advertisements contributed to medication fears.
Hopes and expectations for treatment ranged from those that were symptom or functional status-based, such as desiring mood stabilization and elimination of specific symptoms (23%, N = 21), to more global hopes such as "being normal" (20%, N = 18) or "cured" (18%, N = 16).