Tài liệu Báo cáo y học: "Special considerations in the treatment of patients with bipolar disorder and medica

Patients with bipolar disorder are among the most challenging to treat pharmacologically, especially in the presence of medical comorbidity. Although the rates ofmedical comorbidity are high in patients with bipolar disorder (20–80%), medical illnesses are frequently under-diagnosed and inadequately treated in psychiatricpatients. For example, Cradock-O'Leary and colleaguesreviewed centralized Veterans Affairs data and examinedthe use of medical services by 175,653 veterans during fiscal year 2000 [1]. They identified 3,694 veterans with aprimary diagnosis of bipolar disorder and compared thecare that these veterans received to that of all veterans.Among all veterans with diabetes and hypertension, thosewith a comorbid diagnosis of bipolar disorder (as well asthose with diagnoses of anxiety disorder, schizophrenia,posttraumatic stress disorder,