Group members Gurpreet kaur Amritpal kaur Arshdeep singh uppal Sandeep kaur bhullar

INDEX Introduction Bipolar disorder I and II definitions Prevalence Diagnostic tools Importance of tools Implication in our field Future directions Conclusion

Assessment tools for adult Bipolar Disorder

Main focus In this article, main focus is on the assessment of bipolar disorder in the adults. The research is based on the valid measures for the bipolar disorder related to behind assessment of other disorders such as depression. The crucial review of this article is on—  Diagnostic tools

Cont.…  Self report measures for screening of bipolar diagnosis  Symptom severity measures  Lack of research data from multiple domains relevant to bipolar disorders.

Prevalence Studies indicates a prevalence of 1% of bipolar 1 and 3% of bipolar 2 disorder. The study suggest that heritability accounts for more 90% of the variability in the development of bipolar disorder.

ASSESSMENT TOOLS FOR DIAGNOSIS

The diagnosis of bipolar disorder is based on a review of symptom. In clinical practice, symptoms are frequently reviewed in an unstructured manner. It should be noted, though, that when practitioners do not use structured diagnostic tools, as many as half of comorbid conditions go undetected.

Diagnostic tools  SCID- Structured Clinical Interview for DSM-IV  SADS- Schedule for Affective Disorders and Schizophrenia  GBI- General Behaviour Inventory

Cont.. Several semi structured interviews have been developed to assess bipolar disorders in adults. Two most commonly used measures are Structured Clinical Interview for DSM IV (SCID) and the Schedule for Affective Disorder and Schizophrenia (SADS). The SCID and SADS both provides interview probes, symptom thresholds and information about exclusion criteria (i.e., medical or pharmacological conditions that may induce mania).

SCID SCID- It is designed to help assess diagnoses according to the DSM-IV. It is recommended as a routine part of clinical intake procedures. The SCID is a semi structured interview that is divided into modules to cover different diagnoses. Each SCID module contains probes to cover each of the core symptoms, and interviewers can use clinical judgment in gathering supplemental information if probes do not provide sufficient information for reliable symptom assessment.

SADS SADS- It is designed to assess diagnoses according to the Research Diagnostic Criteria (RDC). It helps to assess a broad range of Axis-I diagnosis. For each diagnosis, the probes focus on the symptoms for the most recent episode and then capture a broad overview of past episodes. The SADS has demonstrated good to excellent reliability for both symptoms and diagnoses.

Diagnostic Assessment of Bipolar II Disorder in Adults The accurate assessment of bipolar II disorder is more difficult to achieve than bipolar I disorder. Hypomania is a unique among DSM syndrome, by definition it does not cause any functional impairment. Perhaps because of this quality, the presence of at least one major depressive episode is also required to achieve a diagnosis of bipolar II disorder This presents a unique diagnostic challenge: the hypomanic episodes that separate bipolar II disorder from unipolar depression.

Cont. … For instance, current DSM criteria require three or four symptoms, in addition to elevated or irritable mood, lasting at least four days. In contrast, RDC criteria only require three symptoms lasting two days. It is not surprising that the accurate assessment of bipolar II disorder is more difficult to achieve than bipolar I disorder.

Self- report measures The most reliable and valid way to obtain a diagnosis of bipolar disorder is through a structured interview with a trained clinician. Several self-report measures have been developed to help clinicians identify persons most likely to meet criteria for bipolar disorders.

GBI  GBI (General Behaviour Inventory) has the most robust psychometric properties of available self- report screeners.  The General Behaviour (GBI) was designed to cover the core symptoms of bipolar disorder, including both depressive and manic symptoms.  At present, the GBI appears to be a useful screening tool for bipolar disorder, but future research to establish norms would increase its utility.

AESSESSMENT OF SYMPTOMS SEVERITY OF YMRS The most common approach to measuring the severity of symptoms has been clinician related interview. The young mania rating scale (YMRS) is most commonly used to track changes in symptoms over time as a treatment progress. It is a minutes interview designed to be conducted by trained clinician. It is based on patient’s report of manic symptoms over the previous two days as well as clinician observation during interview. It is consist of 11 items such as-

Cont.… Mood Motor activity Interest in sex Sleep Irritability Speech, flight of ideas Grandiosity, aggressive behaviour Appearance and patient insight 7 items are rated on a severity scale ranging from 0-4 and 4 items are rated on scale of 0-8

Importance of assessment tool in our course Awareness of differentiate the symptoms of bipolar disorders along with other leading disorders in mental health. It is beneficial way to recognize the needs of the suffering person. Assessment, screening, symptom severity, self report measures and semi structured interview are crucial aspects that helps us to right diagnose of every mental illness.

Cont.… During clinical interview IPR (Interpersonal relationships) and communication is essential which we learnt during this course. If we are successful to do right assessment then only right treatment will be provided to patient and recovery will be possible at right time.

Implication in our field Effective assessment skills helps us to treat client with mental illness. As we learn from this article that quality of life and social interactions are important aspects in mental health field i.e. knowledge resource for us. During conducting interviews and self report from client which are important skills required as a mental health worker, for e.g. asking open ended question. We should become client oriented rather than self oriented as right gathered resources will only help to right diagnose, for instance - difference between bipolar I and II according to sign and symptoms.

What does it mean to us? It is helpful to know more about psychology of other person as well as reassess our criteria. It is useful for us to gain self awareness, self motivation, confidence and knowledge. We become more effective to maintain therapeutic relationships during interview sessions. We can enhance our communication skills in our personal and social life.

CONCLUSION This article has summarized assessment tools for screening, diagnosis and symptoms monitoring within bipolar disorder. We have discussed varies scales of assessment measures of bipolar disorder. After gathering information from article we will be able to amplify these skills in our personal as well as in professional life.

Questions  Difference between Bipolar I and II?  What are the assessment tools for Bipolar disorder?  What are future directions?