BIPOLAR DISORDER

The management of bipolar

disorder in adults, children
Institute for
andNational
adolescents,
in Health
primary
andand
Clinical
Excellencecare
(NICE)
secondary
July 2006

General guidance for

psychology:
Working with patients and
Collaborative relationships
families
Advise on self-monitoring, lifestyle,
coping
Advance directives
Consider impact on relationships,
parenting; carers needs
Accessibility

General guidance for

psychology:
Specific groups of patients
Coincidence of learning disability,

personality difficulty: offer same

care for bipolar disorder
Coincidence of substance misuse:
psychosocial intervention

General guidance for

psychology:
Recognition and treatment
Refer urgently for acute mania, severe
pathway
depression

Refer promptly for hypomania

Consider review if functioning declines or
response to treatment is poor
Risk assessment, crisis plan with triggers
Treat as severe mental illness; offer
specialist services accordingly

General guidance for

psychology:
Healthy lifestyle, relapse
Advice on sleep and daily routine
prevention
Risks of shift work, long hours, flights
Methods of self-monitoring
Extra support after difficult life
events
Collaborative relapse prevention
strategy

Specific guidance for

psychology:
Symptom clusters
Depression: 16-20 sessions CBT for

chronic/recurrent depressive
symptoms (Use CBT in preference to
antidepressants in pregnancyplanning women)
Anxiety: Focussed psychological
treatment

Specific guidance for

psychology:
Post-acute episode--individual
Consider individual structured
Consider individual structured

psychological interventions, such as

CBT
16 sessions over 6-9 months

Psychoeducation
Relapse prevention
Enhance general coping
Delivered by those familiar with bipolar
patients

Specific guidance for

psychology:
Post-acute episodefamily,
Consider family intervention, 6-9
psychosocial
intervention
months

Psychoeducation
Improved communication
Problem solving

Befriending schemes

WorkshopCase vignettes
3 questions: Each group can ask 3
questions to contribute to their
understanding of the case
Consider the risks
Develop a formulation
Accordingly, develop a therapeutic
care plan