Interventions for Bipolar Disorders

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Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community engagement [community sensitization on bipolar disorder, healthy diets, exercise] Education directed at elimination of stigmatization of people living with mental health conditions Provision of IEC/BCC materials			Promote functioning in activities of daily living and rehabilitation and inclusion in the community Early recognition of the need for referral
Primary Care
			Assessment for symptoms of anxiety Referral to the next level for specialized mental health investigation
Referral Facility: General
			History and physical examination for bipolar disorder Basic laboratory tests Assessment of self-harm and suicide risk in people with mental, neurological, and substance use conditions Promote functioning in activities of daily living and rehabilitation and inclusion in the community Psychoeducation and psychosocial support (including for patient’s carers) Provide cognitive behavioural therapy or interpersonal therapy for bipolar disorders Oral anticholinergic medications for drug induced extrapyramidal side effects Oral lithium for bipolar disorder Oral antipsychotics for bipolar disorder Oral anticonvulsants for bipolar disorder Intravenous long-acting benzodiazepine for bipolar disorder Monitoring of lithium and other mood stabilizers and antipsychotic medicines
Referral Facility: Specialist
			History and physical examination for bipolar disorder Basic laboratory tests Assessment of self-harm and suicide risk in people with mental, neurological, and substance use conditions Promote functioning in activities of daily living and rehabilitation and inclusion in the community Psychoeducation and psychosocial support (including for patient’s carers) Provide cognitive behavioural therapy or interpersonal therapy for bipolar disorders Oral anticholinergic medications for drug induced extrapyramidal side effects Oral lithium for bipolar disorder Oral antipsychotics for bipolar disorder Oral anticonvulsants for bipolar disorder Intravenous long-acting benzodiazepine for bipolar disorder Monitoring of lithium and other mood stabilizers and antipsychotic medicines

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community engagement [community sensitization on bipolar disorder, healthy diets, exercise] Education directed at elimination of stigmatization of people living with mental health conditions Provision of IEC/BCC materials	Encourage compliance with medications		Promote functioning in activities of daily living and rehabilitation and inclusion in the community Early recognition of the need for referral
Primary Care
			Assessment for symptoms of anxiety Referral to the next level for specialized mental health investigation
Referral Facility: General
			Psychoeducation and psychosocial support (including for patient’s carers) Provide cognitive behavioural therapy or interpersonal therapy for bipolar disorders Oral anticholinergic medications for drug induced extrapyramidal side effects Oral lithium for bipolar disorder Oral antipsychotics for bipolar disorder Oral anticonvulsants for bipolar disorder Intravenous long-acting benzodiazepine for bipolar disorder Monitoring of lithium and other mood stabilizers and antipsychotic medicines
Referral Facility: Specialist
			Cognitive behavioural therapy or interpersonal therapy for bipolar disorders Oral anticholinergic medications for drug induced extrapyramidal side effects Oral lithium for bipolar disorder Oral antipsychotics for bipolar disorder Oral anticonvulsants for bipolar disorder Intravenous long-acting benzodiazepine for bipolar disorder Monitoring of lithium and other mood stabilizers and antipsychotic medicines

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community engagement [community sensitization on psychiatric disorders, healthy diets, exercise, stress management, healthy relationships] Education directed at elimination of stigmatization of people living with mental health conditions	Early identification of the warning signs of an approaching episode to seek early treatment	Recognition signs and symptoms of mental health disorders	Early identification and referral	Regular social, educational and occupational support	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to address financial well-being of patients and family members
Primary Care
Education of patients and families on medication compliance, the various symptoms and signs of the disorder	Early identification of the warning signs of an approaching episode to seek early treatment	Recognition signs and symptoms of mental health disorders	Psychoeducation cognitive behavioural therapy (CBT) Family-focused therapy	Regular social, educational and occupational support	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to address financial well-being of patients and family members
Referral Facility: General
Education of patients and families on medication compliance, the various symptoms and signs of the disorder		History Physical examination Psychiatric assessment	Mood stabilizers (e.g. Lithium) Antipsychotics Combination therapy (mood stabilizer and antipsychotics) Electroconvulsive therapy Psychoeducation cognitive behavioural therapy (CBT) Interpersonal and social rhythm therapy (IPSRT) Family-focused therapy Monitor drug adverse effects	Regular social, educational and occupational support	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to address financial well-being of patients and family members
Referral Facility: Specialist
Education of patients and families on medication compliance, the various symptoms and signs of the disorder		History Physical examination Psychiatric assessment	Mood stabilizers Antipsychotics Atypical antipsychotics Combination therapy (mood stabilizer and antipsychotics) Electroconvulsive therapy Psychoeducation cognitive behavioural therapy (CBT) Interpersonal and social rhythm therapy (IPSRT) Family-focused therapy Monitor drug adverse effects	Regular social, educational and occupational support	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to address financial well-being of patients and family members