Pedro Levy, Portugal

What’s your opinion on combining psychiatric and psychotherapeutic approaches to care?

I think that it should be done on a regular basis, in the hospital, community care and private sector. I use that kind of approach, with psychotherapeutic information, in my patients, but some them I think really need some more specific psychotherapy too. Not all. I think all should have some psychoinformation, but some need more specific psychotherapeutic approaches than others. The general information about the disease should be for everyone.

Could you describe the ways in which patients suffering bipolar mania with depressive symptoms are particularly burdened by their condition? (e.g. symptoms or comorbidities)

I have a group of patients that, besides bipolar disorders, have addiction disorders and I think it’s mostly important to tackle the addiction disorder and bipolar disorder. And it becomes more complicated when you have a bipolar disorder with mixed affective states. I think it’s very difficult to tackle them because they don’t adhere to any treatment. Sometimes I have to make an in-patient treatment – a community-based treatment or a hospital-based treatment – because they don’t adhere too easily. Many of them, they begin treatment and after four, five days will relapse on the addiction and everything is changed again. That’s one of my main problems with patients suffering from mixed states.