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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_173_библиотеки_им_акад_М_И_Перельмана
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Evidence-based
Pharmacotherapy,
Cognitive Behavioral
Psychotherapy and
Rehabilitation
Stavroula Rakitzi
Polyxeni Georgila
Treatment-
Resistant Bipolar
Disorder
Treatment-Resistant Bipolar Disorder
StavroulaRakitzi • PolyxeniGeorgila
Treatment-Resistant
Bipolar Disorder
Evidence-based Pharmacotherapy,
Cognitive Behavioral Psychotherapy
andRehabilitation
StavroulaRakitzi
Clinical psychology and cognitive
behavioral psychotherapy
Private practice
ILISION 34 15771, Athens, Greece
PolyxeniGeorgila
Psychiatry and cognitive behavioral
psychotherapy
Private practice
ILISION 34 15771, Athens, Greece
ISBN 978-3-031-59000-9 ISBN 978-3-031-59001-6 (eBook)
https://doi.org/10.1007/978-3-031-59001-6
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland
AG 2024
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specic statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
If disposing of this product, please recycle the paper.
This book is devoted to all the people with
bipolar disorder and treatment-resistant
bipolar disorder; to my patients with
treatment-resistant bipolar disorder; to my
parents and my family; to my colleague
Polyxeni Georgila; and to Prof. Dr. Annette
Schröder, my supervisor in my Ph.D. studies
at the University of Koblenz-Landau,
Germany.
Stavroula Rakitzi
This book is devoted to all the people with
bipolar disorder and treatment-resistant-
bipolar disorder; to my patients with
treatment-resistant bipolar disorder; to my
three daughters and to my sisters; to my
parents; to my mentor Prof. E.Garelis; and
to my colleague Stavroula Rakitzi.
Polyxeni Georgila
https://t.me/med1917
vii
Preface
This book is about the modern and evidence-based interventions in treatment-
resistant bipolar disorder that are being executed these days.
Furthermore, this book presents a modern point of view from us with respect to
the therapy of treatment-resistant bipolar disorder—a new long-term recovery-
oriented treatment as a combination of pharmacotherapy and cognitive behavioral
therapy and rehabilitation.
This manual presents our clinical experience with treatment-resistant bipolar dis-
order. This subcategory of individuals with bipolar disorder faced numerous issues.
So, it is exceptionally critical to have a conversation about a new point of view
regarding the therapy of this subgroup. Our new recovery-oriented model guaran-
tees a new beginning regarding therapy for people with treatment-resistant bipolar
disorder and their families.
The mental health experts can, moreover, be propelled by our model in their own
clinical practice.
The clinical psychiatrists, clinical psychologists, cognitive behavioral psycho-
therapists, students of psychology and medicine, and researchers can benet as
readership from this manual.
Athens, Greece StavroulaRakitzi
Athens, Greece PolyxeniGeorgila
https://t.me/med1917
ix
Introduction
Treatment-Resistant Bipolar Disorder: Evidence-Based Pharmacotherapy,
Cognitive Behavioral Psychotherapy and Rehabilitation presents an inclusive book
about one of the most troublesome chronic mental health disorders, treatment-
resistant bipolar disorder. Evidence-based treatments for treatment-resistant bipolar
disorder, such as pharmacotherapy, cognitive behavioral psychotherapy, and reha-
bilitation, will be analyzed. A new recovery-oriented model for treatment-resistant
bipolar disorder will be proposed. This book may be a valuable manual for experts,
such as clinical psychiatrists, clinical psychologists, cognitive behavioral psycho-
therapists, and researchers, as well as students of psychology and medicine.
https://t.me/med1917
xi
Acknowledgments
We are thankful to all of our patients with bipolar disorder and treatment-resistant
bipolar disorder, who have participated in our treatments. We are also thankful to
Dr. Sylvana Freyberg from Springer Nature and of course to Springer Nature.
Ethics Approval We adhere to the ethical standards of the 1964 Declaration of
Helsinki and its subsequent alterations. We have included a statement that consent
for publication was obtained from the participating individuals.
Competing Interests We declare that we have no competing nancial or nonnan-
cial interests in connection with the content of this book.
https://t.me/med1917
xiii
About this Book
Treatment-resistant bipolar disorder presents one of the most difcult mental health
disorders, which is associated with a high possibility of relapse, repetitive hospital-
izations, suicidal behavior, and interpersonal problems.
This book focuses on treatment-resistant bipolar disorder, its clinical character-
istics, and evidence-based treatments—pharmacotherapy, cognitive behavioral psy-
chotherapy, and rehabilitation.
A new long-term recovery-oriented therapy for treatment-resistant bipolar disor-
der will be displayed.
Each chapter starts with an abstract, followed by learning objectives, an intro-
duction, the main text, discussion, conclusions, revision questions, and a bibliogra-
phy. The learning objectives and revision questions stimulate the learning of the
readership. It can also contribute to the enhancement of the educational process in
workshops and courses.
Dr. Stavroula Rakitzi
Dr. Polyxeni Georgila
Athens, Greece
January 2024
https://t.me/med1917
xv
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Recovery in Chronic Mental Health Disorders, Especially
in Bipolar Disorder, and in Treatment-Resistant
Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.1 The Recovery Process and Its Signicance . . . . . . . . . . . . . . . . . . . . 9
2.2 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3 Treatment-Resistant Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3.2 Diagnostic Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.3 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.4 Comorbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.5 Evidence-Based Pharmacotherapy, Cognitive Behavioral
Psychotherapy, and Rehabilitation in Treatment-Resistant
Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.6 Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.7 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.8 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
4 A New Recovery-Oriented Treatment Model
for Treatment-Resistant Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . 49
4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
4.2 Recovery-Oriented Pharmacotherapy for Bipolar Disorder
and Treatment-Resistant Bipolar Disorder (P. Georgila) . . . . . . . . . . 52
4.3 Recovery-Oriented Cognitive-Behavioral Psychotherapy
and Metacognitive Training for Bipolar Disorder
and Treatment-Resistant Bipolar Disorder (S. Rakitzi) . . . . . . . . . . . 54
4.4 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
4.5 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
5 Epilogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
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