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CME: Bipolar: Barriers to Care, Therapeutic Updates, and Best Practices

Activity Description / Statement of Need:

In this online CME self-learning program:


Bipolar disorder is a mood disorder characterized by episodes of mania, hypomania, and depression. It affects 3-4% of the U.S. population, represents a substantial societal and economic burden in the United States, is also found to be strongly associated with other major public health concerns like diabetes and cardiovascular disease as well as suicide.


The literature demonstrates that medication nonadherence is a major issue among patients with bipolar disorder. Nonadherence affects approximately 60% of patients and can result in hospitalization, poor effectiveness, increased relapses, and increased risk of morbidity. Inadequate medication adherence can lead to poor clinical outcomes and increased healthcare costs;  healthcare practitioners must remain cognizant and vigilant in identifying factors that may adversely impact adherence. One major barrier is side effects of therapy, particularly weight gain. Other factors, such as patient perceptions, illness severity, and the relationship between the physician and patient, come into play and should be taken into account to optimize adherence.


This program has been designed to bring healthcare professionals’ knowledge up to date with the current and emerging therapies and best practices bipolar disorder and to improve their competence and performance in treating it.




Introduction, Disclosures

Epidemiology of bipolar disorder

  • Statistics (prevalence of disease)
  • Impact on society (economic burden, role as a public health concern)
  • Comorbid diseases (ADHD, depression, anxiety, etc)

Symptomology and diagnosis of bipolar disorder

  • DSM-IV-TR / 5 criteria
  • Differential diagnosis
    • Medical history
    • Substance history
    • Psychiatric history
  • Patient case(s)

Treatment with an emphasis on bipolar disorder I

  • Therapies: non-pharmacological vs. pharmacological, first-line and beyond
    • Prescription medications
  • Acute treatment of mania
  • Mixed episodes
    • Role of cognitive behavioral therapy
  • Special populations (adolescents, elderly, patients with comorbid diseases, etc)
  • What’s on the horizon: emerging therapy
  • Best practice: putting it all together
  • Patient case(s)

Barriers to optimal care in patients with bipolar disorder

  • Adherence (side effects, patient perception, etc)
  • Existence of comorbid diseases
  • Patient case(s)

Summary, conclusions, and best practice recap

Target Audience:

Health care professionals specializing in: pediatric or adult psychiatry, mental health, primary care, and those who otherwise commonly care for patients with bipolar disorder or other related psychiatric disorders.

This program is supported by an educational grant from Forest / Actavis / Watson

Release Date: October 01, 2015 -- Expiration Date: October 01, 2017

Faculty: Darin Signorelli, MD


Learning Objectives

By the end of the session the participant will be able to:

  • Describe the challenges, including comorbid conditions, associated with diagnosis of bipolar disorder.
  • Apply existing screening practices and diagnostic criteria to patients with bipolar disorder.
  • Identify current and emerging treatment modalities for the management of bipolar disorder* and apply them to patient cases using evidence-based medicine.
  • Evaluate a specific patient during the maintenance phase of therapy and suggest modifications for improvement, taking into account: efficacy; changes in symptoms, adverse effects of therapy; and the disease and treatment´┐Żs impact on quality of life.
  • Describe the challenges associated with treating patients with bipolar disorder, including medication adherence, and incorporate that knowledge in an effort to optimize communication with patients during the initial patient presentation, first stages of treatment, and follow up.



Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure:  Dr. Darin Signorelli MD has no significant financial relationships to disclose.


Disclosures of Educational Planners: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC.


Commercial Support Disclosure: This program is supported by an educational grant from Forest / Actavis / Watson


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.