Bipolar Ii Disorder and Comorbidity of Alcohol Abuse or Dependence

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Bipolar II Disorder and Comorbidity of Alcohol Abuse or Dependence by

Bachelor of Science
Mount Olive College, 2009

Submitted in Partial Fulfillment of the Requirements
For the Degree of Bachelor of Science in
Business Administration: Health Care Management
Tillman School of Business
Mount Olive College
2009

MOUNT OLIVE COLLEGE

Thesis Certification

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Applicant
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Thesis titleBipolar II Disorder and Comorbidity of Alcohol abuse or

Dependence

Intended date of commencement October 15, 2009

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Level of Honors conferred:University
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I
Table of Contents
FACULTY CERTIFICATION PAGE…………………………………………………………..APPENDIX I TABLE OF CONTENTS……………………………………………………………………….PAGE 4 CHAPTER 1: INTRODUCTION……………………………………………………………..PAGE 5 CHAPTER 2: LITERATURE REVIEW……………………………………………………….PAGE 7-28 CHAPTER 3: RESEARCH METHODOLOGY……………………………………………….PAGE 29-30 REFERENCES………………………………………………………………………………….PAGE 31-32

Chapter I
Introduction
Bipolar disorder dates back to the time of Hippocrates (Healy). Hippocrates was the first to put mania and melancholia on our cultural radar (Healy). The symptoms he used to diagnose mania were that of nausea, shivering, insomnia, and lack of thirst (Healy). Until recently, bipolar II disorder has been virtually unknown and highly underdiagnosed. DSM-IV has separated bipolar disorders into two types, bipolar II and I. (Chengappa, Levine, Gershon, Kupfer). These two disorders may have differing genetic, biological, phenomenological attributes and course of illness characteristics (Chengappa, Levine, Gershon, Kupfer). There are many reasons for this. A lack of education regarding the disorder, misdiagnosis, and improper treatments are the number one reason for misdiagnosis. Physicians and mental health clinicians are just now learning the symptoms of bipolar II disorder. During a 2005 chart review, 37% of 90 bipolar II disorder patients were misdiagnosed as having unipolar depression. Bipolar II disorder is defined, by DSM-IV, as recurrent episodes of depression and hypomania (Benazzi, F). Hypomania requires elevated (euphoric) and/or irritable mood, plus at least three of the following symptoms (four if mood is only irritable): grandiosity, decreased need for sleep, increased talking, racing thoughts, distractibility, overactivity (an increase in goal-directed activity), psychomotor agitation and excessive involvement in risky behaviors (Benazzi, F.). Unlike with bipolar I disorder, there is no impairment of social or occupational functioning, or hospitalization (Benazzi, F). The results of one study found that 57.8% of participants with bipolar I disorder abused, or were dependent on one or more substances or alcohol. Nearly 39% of bipolar II subjects abused or were dependent on one or more substances, 17% were dependent on two or more substances or alcohol, and 11% were dependent on three or more substance or alcohol. Alcohol abuse was the most commonly abuse drug between both groups (Chengappa, Levine, Gershon, Kupfer). According to the Epidemiologic Catchment Area (ECA), the lifetime prevalence for substance abuse in bipolar disorder are higher than those reported for other major mental disorders, such as schizophrenia or unipolar major depression (Chengappa, Levine, Gershon, Kupfer). Furthermore, bipolar disorder was the psychiatric condition most likely to occur comorbidly with a substance abuse disorder (Chengappa, Levine, Gershon, Kupfer). Twenty journals have been reviewed for this research paper and twenty journals...
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