Comorbidities and CANMAT

Professor Diane McIntosh, Clinical Associate Professor at the University of British Columbia explained how new guidelines and recommendations such as DSM-5 and CANMAT are helpful in diagnosing the increasingly complex range of symptoms and disease states seen in bipolar disorder.

Speaking about how bipolar patients with mixed features and comorbidities are the norm, not the exception, she explained that she didn’t think she had seen a bipolar patient without anxiety symptoms.

Prof McIntosh highlighted the importance of recognising and treating the comorbid condition, as well as bipolar disorder, as ignoring comorbidities can lead to:

• Longer illness duration
• Greater illness severity
• Higher rates of suicide
• Overall poorer treatment response

But she also acknowledged that, currently, there is a lack of in depth evidence to support some of the more recently developed therapeutics in treating bipolar comorbidities in bipolar disorder, leading to their omission from CANMAT.

Metabolic musings

Professor Roumen Milav, Head of Psychiatry at Queens University, followed on from Prof McIntosh with his talk on the CANMAT principles of treating bipolar patients with metabolic disorders.

Illnesses like obesity, which are rising to epidemic proportions globally, can pose special challenges for patients with mental disorders.

After running through the recommended first, second and ‘not recommended’ treatment approaches (available on the CANMAT website), he stressed the importance of lifestyle and behavioural modifications in treatment, and the positive impact they can have on bipolar patients with comorbidities.

To this correspondent, today’s presentations highlighted the ongoing, evolving and expanding understanding of bipolar disorder and it’s treatment – a great example of how conferences like WPA can bring together varied opinion and expertise on a subject, and result in real progress and results for patients.