COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Under-recognition and Undertreatment
of Depression
• Depression
– 45% untreated
– 44% under treated
– 11% treated appropriately
Hirschfeld et al., 1997
Underrecognition and
Undertreatment: Bipolar Disorder
• More than half do not seek treatment 5
years after first experiencing symptoms.
• 36 percent did not seek treatment after 10
years.
• The correct diagnosis was not made until
an average of 8 years after first seeking
treatment (NDMDA survey).
Undertreatment: Provider Factors
(Hirschfeld,et al,1997)
• Poor education about the disorders
• Limited training in interpersonal skills
•Stigma
• Inadequate time to evaluate and treat
• Failure to consider psychotherapeutic
approaches
• Inadequate doses of medication for
inadequate durations
DSM-IV Mood Disorders
• Major Depressive Disorder
• Dysthymic Disorder
• Depressive Disorder NOS
• Bipolar I Disorder
• Bipolar II Disorder
• Mood Disorder Due to a General Medical Condition
• Substance-Induced Mood Disorder
• Mood Disorder NOS
Comorbidity is Common
(Kessler et al,1996)
• Most people with 1 mental disorder suffer
from 1 or more other disorders
• Mood disorders are risk factors for medical
illness
• Both psychiatric and medical comorbidities
are especially common in those with
bipolar disorder
Some Comorbid Conditions
• Substance related disorders
– Alcohol abuse/dependence most common
• Anxiety disorders
• Impulse Control Disorders (Bipolar
disorder)
– Pathological Gambling and Kleptomania
most common
• Eating Disorders (Bipolar disorder)
• Personality Disorders
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