Non-pharmacological treatments in the management of rapid cycling bipolar disorder

Journal of Affective Disorders

Volumn 98, Issue 1-2, 2007, Pages 1-10

  Papadimitriou, George N ^a   Dikeos, Dimitris G ^a   Soldatos, Constantin R ^a   Calabrese, Joseph R ^b  

^a UNIVERSITY OF ATHENS MEDICAL SCHOOL   (Greece)

^b CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Bipolar disorder; Non pharmacological; Rapid cycling; Treatment

Indexed keywords

BEHAVIOR THERAPY; COGNITIVE THERAPY; ELECTROCONVULSIVE THERAPY; FAMILY THEORY; FAMILY THERAPY; HUMAN; MAJOR DEPRESSION; MOOD DISORDER; PHOTOTHERAPY; PRIORITY JOURNAL; PSYCHOEDUCATION; PSYCHOSOCIAL CARE; PSYCHOTHERAPY; RAPID CYCLING BIPOLAR DISORDER; RECURRENCE RISK; REVIEW; SLEEP DEPRIVATION; SYSTEMATIC REVIEW; TRANSCRANIAL MAGNETIC STIMULATION; TREATMENT INDICATION; TREATMENT OUTCOME; VAGUS NERVE STIMULATION;

ACTIVITY CYCLES; BIPOLAR DISORDER; ELECTROCONVULSIVE THERAPY; PATIENT EDUCATION; PERIODICITY; PHOTOTHERAPY; PSYCHOTHERAPY; SLEEP DEPRIVATION; SOCIAL SUPPORT; TIME FACTORS;

EID: 33845977771     PISSN: 01650327     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jad.2006.05.036     Document Type: Review

References (103)

1. Akiskal H.S., Bourgeois M.L., Angst J., Post R., Moller H., and Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J. Affect. Disord. 59 Suppl. 1 (2000) 5-30
2. Altshuler L.L., Post R.M., Leverich G.S., Mikalauskas K., Roogg A., and Ackerman L. Antidepressant-induced manic and cyclic acceleration: a controversy revisited. Am. J. Psychiatry 152 (1995) 1130-1138
3. Altshuler L.L., Kiriakos L., Calgano J., Goodman R., Gitlin M., Frye M., and Mintz J. The impact of antidepressant discontinuation versus antidepressant continuation on 1-year risk for relapse of bipolar depression: a retrospective chart review. J. Clin. Psychiatry 62 (2001) 612-616
4. Altshuler L.L., Suppes T., Black D., Nolen W.A., Keck Jr. P.E., Frye M.A., McElroy S., Kupka R., Grunze H., Walden J., Leverich G., Denicoff K., Luckenbauch D., and Post R.M. Impact of antidepressant discontinuation after acute bipolar depression remission on rates of depressive relapse at 1-year follow-up. Am. J. Psychiatry 160 (2003) 1252-1262
5. Altshuler L.L., Frye M.A., and Gitlin M.J. Acceleration and augmentation strategies for treating bipolar depression. Biol. Psychiatry 53 (2003) 691-700
6. Altshuler L.L., Suppes T., Black D., Nolen W.A., Leverich G., Keck Jr. P.E., Frye M.A., Kupka R., McElroy S., Grunze H., Kitchen C.M., and Post R.M. Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants. Am. J. Psychiatry 163 (2006) 313-315
7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th revision (2000), American Psychiatric Press DSM-IV-TR
8. American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am. J. Psychiatry 159 suppl. 4 (2002) 1-50
9. Angst J. Switch from depression to mania-a record study over the decades between 1920 and 1982. Psychopathology 18 (1985) 140-154
10. Ashman S.B., Monk T.H., Kupfer D.J., Clark C.H., Myers F.S., Frank E., and Leibenluft E. Relationship between social rhythms and mood in patients with rapid cycling bipolar disorder. Psychiatry Res. 86 (1999) 1-8
11. Bauer M.S., Calabrese J., Dunner D.L., Post R., Whybrow P.C., Gyulai L., Tay L.K., Younkin S.R., Bynum D., Lavori P., and Price R.A. Multisite data reanalysis of the validity of rapid cycling as a course modifier for bipolar disorder in DSM-IV. Am. J. Psychiatry 151 (1994) 506-515
12. Bauer M., Rasgon N., Grof P., Altshuler L.L., Gyulai L., Lapp M., Glenn T., and Whybrow P.C. Mood changes related to antidepressants: a longitudinal study of patients with bipolar disorder in a naturalistic setting. Psychiatry Res. 133 (2005) 73-80
13. Beck A.T., Rush A.J., Shaw B.F., and Emery G. Cognitive Therapy of Depression (1979), Guilford, New York
14. Benazzi F. Antidepressant-associated hypomania in outpatient depression: a 203-case study in private practice. J. Affect. Disord. 46 (1997) 73-77
15. Benedetti F., Barbini B., Fulgosi M.C., Colombo C., Dallaspezia S., Pontiggia A., and Smeraldi F. Combined total sleep deprivation and light therapy in the treatment of drug-resistant bipolar depression: acute response and long-term remission rates. J. Clin. Psychiatry 66 (2005) 1535-1540
16. Berman E., and Wolpert E.A. Intractable manic-depressive psychosis with rapid cycling in an 18-year-old woman successfully treated with electroconvulsive therapy. J. Nerv. Ment. Dis. 175 (1987) 236-239
17. Bhanji S., and Roy G.A. The treatment of psychotic depression by sleep deprivation: a replication study. Br. J. Psychiatry 127 (1975) 222-226
18. Bowden C.L., Calabrese J.R., McElroy S.L., Gyulai L., Wassef A., Petty F., Pope Jr. H.G., Chou J.C., Keck Jr. P.E., Rhodes L.J., Swann A.C., Hirschfeld R.M., and Wozniak P.J. A randomized placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Arch. Gen. Psychiatry 57 (2000) 481-489
19. Calabrese J.R., Shelton M.D., Rapport D.J., Kujawa M., Kimmel S.E., and Caban S. Current research on rapid cycling bipolar disorder and its treatment. J. Affect. Disord. 67 (2001) 241-255
20. Calabrese J.R., Shelton M.D., Bowden C.L., Suppes T., Shirley E.R., Kimmel S.E., and Caban S. Bipolar rapid cycling: focus on depression as its hallmark. J. Clin. Psychiatry 62 Suppl. 14 (2001) 34-41
21. Calabrese J.R., Shelton M.D., Rapport D.J., Youngstrom E.A., Jackson K., Bilali S., Ganocy S.J., and Findling R.L. A 20-month, double-blind, maintenance trial of lithium versus divalproex in rapid-cycling bipolar disorder. Am. J. Psychiatry 162 (2005) 2152-2161
22. Christodoulou G.N., Malliaras D.E., Lykouras E.P., Papadimitriou G.N., and Stefanis C.N. Possible prophylactic effect of sleep deprivation. Am. J. Psychiatry 135 (1978) 375-376
23. Colom F. Engaging the family in the combined treatment of bipolar disorder. World Psychiatry 3 Suppl. 1 (2004) 33-34
24. Colom F., and Vieta E. A perspective on the use of psychoeducation, cognitive-behavioral therapy and interpersonal therapy for bipolar patients. Bipolar Disord. 6 (2004) 480-486
25. Colom F., Vieta E., Martinez-Aran Reimares M., Goikolea J.M., Benabarre A., Torrent C., Comes M., Corbella B., Parramon G., and Corominas J. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch. Gen. Psychiatry 60 (2003) 402-407
26. Colom F., Vieta E., Sanchez-Moreno J., Martinez-Aran A., Torrent C., Reinares M., Goikolea J.M., Benabarre A., and Comes M. Psychoeducation in bipolar patients with comorbid personality disorders. Bipolar Disord. 6 (2004) 294-298
27. Compton M.T., and Nemeroff C.B. The treatment of bipolar depression. Clin. Psychiatry 61 Suppl. 9 (2000) 57-67
28. Coryell W., Endicott J., and Keller M. Rapidly cycling affective disorder: demographics, diagnosis, family history, and course. Arch. Gen. Psychiatry 49 (1992) 126-131
29. Coryell W., Solomon D., Turvey C., Keller M., Leon A.C., Endicott J., Scettler P., Judd L., and Mueller T. The long-term course of rapid cycling bipolar disorder. Arch. Gen. Psychiatry 60 (2003) 914-920
30. Dunner D.C., and Fieve R.R. Clinical factors in lithium carbonate prophylaxis failure. Arch. Gen. Psychiatry 30 (1974) 229-233
31. Eagles J.M. The relationship between mood and daily hours of sunlight in rapid cycling bipolar illness. Biol. Psychiatry 36 (1994) 422-424
32. Fava G.A., Savron G., Grandi S., and Rafanelli C. Cognitive behavioral treatment of drug resistant major depression disorder. J. Clin. Psychiatry 58 (1997) 278-282
33. Fink M. Convulsive therapy: a review of the first 55 years. J. Affect. Disord. 63 (2001) 1-15
34. Frances A., Kahn D.A., Carpenter D., Docherty J.P., and Donovan S.L. The expert consensus guidelines for treating depression in bipolar disorder. J. Clin. Psychiatry 59 Suppl. 4 (1998) 73-79
35. Frank E., Kupfer D.J., Ehlers C.L., Monk T.H., Cornes C., Carter S., and Frankel D. Interpersonal and social rhythm therapy for bipolar disorder: integrating interpersonal and behavioral approaches. Behav. Ther. 17 (1994) 143-149
36. Frank E., Hlastala S., Ritenour A., Houck P., Tu X.M., Monk T.H., Mallinger A.G., and Kupfer D.J. Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol. Biol. Psychiatry 41 (1997) 1165-1173
37. Frank E., Swartz H.A., and Kupfer D.J. Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biol. Psychiatry 48 (2000) 593-604
38. Frank E., Kupfer D.J., Thase M.E., Mallinger A.G., Swartz H.A., Fagiolini A.M., Grochocinski V., Houck P., Scott J., Thomson W., and Monk T. Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch. Gen. Psychiatry 62 (2005) 996-1004
39. Frye M.A., Ketter T.A., Leverich G.S., Huggins T., Lantz C., Denicoff K.D., and Post R.M. The increasing use of polypharmacotherapy for refractory mood disorders: 22 years of study. J. Clin. Psychiatry 61 (2000) 9-15
40. George M.S., Wasserman E.M., Kimbrell T.A., Little J.T., Williams W.E., Danielson A.L., Greenberg B.D., Hallett M., and Post R.M. Mood improvement following daily left prefrontal repetitive transcranial magnetic stimulation in patients with depression: a placebo-controlled crossover trial. Am. J. Psychiatry 154 (1997) 1752-1756
41. George M.S., Nahas Z., Lisanby S.H., Schlaepfer T., Kozel F.A., and Greenberg B.D. Transcranial magnetic stimulation. Neurosurg. Clin. N. Am. 14 (2003) 283-301
42. Gill D.S., Ketter T.A., and Post R.M. Antidepressant response to sleep deprivation as a function of time into depressive episode in rapidly cycling bipolar patients. Acta Psychiatr. Scand. 87 (1993) 102-109
43. Golden R.N., Gaynes B.N., Ekstrom R.D., Hamer R.M., Jacobsen F.M., Suppes T., Wisner K.L., and Nemeroff C.B. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am. J. Psychiatry 162 (2005) 656-662
44. Goldstein M.J., and Miklowitz D.J. Family intervention for persons with bipolar disorder. New Dir. Ment. Health Serv. 62 (1994) 23-35
45. Goodwin G.M. Prophylaxis of bipolar disorder: how and who should we treat in the long term?. Eur. Neuropsychopharmacol. 9 suppl. 4 (1999) 125-129
46. Goodwin F.K., and Jamison K.R. Manic Depressive Illness (1990), Oxford University Press, New York
47. Grunhaus L., Schreiber S., Dolberg O.T., Polak D., and Dannon P.N. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol. Psychiatry 53 (2003) 324-331
48. Hirschfeld R.M.A. Guideline Watch: Practice Guideline for the Treatment of Patients with Bipolar Disorder (2006), American Psychiatric Association, Arlington, VA
49. Hopkins H.S., and Gelenberg A.J. Treatment of bipolar disorder: how far have we come?. Psychopharmacol. Bull. 30 (1994) 27-38
50. Jones S. Psychotherapy of bipolar disorder: a review. J. Affect. Disord. 85 (2004) 101-114
51. Judd L.L., Akiskal H.S., Schettler P.J., Coryell W., Endicott J., Maser J.D., Solomon D.A., Leon A.C., and Keller M.B. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch. Gen. Psychiatry 60 (2003) 261-269
52. Kho K.H. Treatment of rapid cycling bipolar disorder in the acute and maintenance phase with ECT. J. ECT 18 (2002) 159-161
53. Kilzieh N., and Akiskal H.S. Rapid-cycling bipolar disorder. An overview of research and clinical experience. Psychiatr. Clin. North Am. 22 (1999) 585-607
54. Kington D.G., Farr P., Murphy S., and Tyrer P. Hypomania following cognitive therapy. Br. J. Psychiatry 149 (1986) 383-384
55. Koukopoulos A., Sani G., Koukopoulos A.E., Minnai G.P., Girardi P., Pani L., Albert M.J., and Reginaldi D. Duration and stability of the rapid-cycling course: a long-term personal follow-up of 109 patients. J. Affect. Disord. 73 (2003) 75-85
56. Kukopulos A., Caliari B., Tundo A., Minnai G., Floris G., Reginaldi D., and Tondo L. Rapid cyclers, temperament, and antidepressants. Compr. Psychiatry 24 (1983) 249-258
57. Kupka R.W., Luckenbaugh D.A., Post R.M., Leverich G.S., and Nolen W.A. Rapid and non-rapid cycling bipolar disorder: a meta-analysis of clinical studies. J. Clin. Psychiatry 64 (2003) 1483-1494
58. Lam D.H., Watkins E.R., Hayward P., Bright J., Wright K., Kerr N., Parr-Davis G., and Sham P. A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder. Arch. Gen. Psychiatry 60 (2003) 145-152
59. Leibenluft E., Moul D.E., Schwartz P.J., Madden P.A., and Wehr T.A. A clinical trial of sleep deprivation in combination with antidepressant medication. Psychiatry Res. 46 (1993) 213-227
60. Leibenluft E., Turner E.H., Feldman-Naim S., Schwartz P.J., Wehr T.A., and Rosenthal N.E. Light therapy in patients with rapid cycling bipolar disorder: preliminary results. Psychopharmacol. Bull. 31 (1995) 705-710
61. Leibenluft E., Albert P.S., Rosenthal N.E., and Wehr T.A. Relationship between sleep and mood in patients with rapid-cycling bipolar disorder. Psychiatry Res. 63 (1996) 161-168
62. Leverich G.S., Altshuler L.L., Frye M.A., Suppes T., McElroy S., Keck Jr. P.E., Kupka R.W., Denicoff K.D., Nolen W.A., Grunze H., Martinez M.I., and Post R.M. Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. Am. J. Psychiatry 163 (2006) 232-239
63. Li X., Nahas Z., Anderson B., Kozel F.A., and George M.S. Can left prefrontal rTMS be used as a maintenance treatment for bipolar depression?. Depress. Anxiety 20 (2004) 98-100
64. Mackin P., and Young A.H. Rapid cycling bipolar disorder: historical overview and focus on emerging treatments. Bipolar Disord. 6 (2004) 523-529
65. Maj M., Magliano L., Pirozzi R., Marasco C., and Guarneri M. Validity of rapid cycling as a course specifier for bipolar disorder. Am. J. Psychiatry 151 (1994) 1015-1019
66. Maj M., Pirozzi R., Magliano L., and Bartoli L. Long-term outcome of lithium prophylaxis in bipolar disorder: a 5-year prospective study of 402 patients at a Lithium Clinic. Am. J. Psychiatry 155 (1998) 30-35
67. Matthews K., and Eljamel M.S. Vagus nerve stimulation and refractory depression. Please can you switch me on doctor?. Br. J. Psychiatry 183 (2003) 181-183
68. Miklowitz D.J. Psychotherapy in combination with drug treatment for bipolar disorder. J. Clin. Psychiatry 16 (1996) 56-66 (suppl.)
69. Miklowitz D.J., Simoneau T.L., George E.L., Richards J.A., Kalbag A., Sachs-Ericsson N., and Suddath R. Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy. Biol. Psychiatry 48 (2000) 582-592
70. Miklowitz D.J., Richards J.A., George E.L., Frank E., Suddath R.L., Powell K.B., and Sacher J.A. Integrated family and individual therapy for bipolar disorder: results of a treatment development study. J. Clin. Psychiatry 64 (2003) 182-191
71. Miller I.W., Solomon D.A., Ryan C.E., and Keitner G.I. Does adjunctive family therapy enhance recovery from bipolar I mood episodes?. J. Affect. Disord. 82 (2004) 431-436
72. Nahas Z., Molloy M.A., Hughes P.L., Oliver N.C., Arana G.W., Risch S.C., and George M.S. Repetetive transcranial magnetic stimulation: perspectives for application in the treatment of bipolar and unipolar disorders. Bipolar Disord. 2 (1999) 73-80
73. Nahas Z., Marangell L.B., Husain M.M., Rush A.J., Sackeim H.A., Lisanby S.H., Martinez J.M., and George M.S. Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. J. Clin. Psychiatry 66 (2005) 1097-1104
74. Nedjat S., and Folkerts H.W. Induction of a reversible state of hypomania by rapid-rate transcranial magnetic stimulation over the left prefrontal lobe. J. ECT 15 (1999) 166-168
75. Otto M.W., Reilly-Harrington N., and Sachs G.S. Psychoeducational and cognitive-behavioral strategies in the management of bipolar disorder. J. Affect. Disord. 73 (2003) 171-181
76. Papadimitriou G.N., Christodoulou G.N., Katsouyanni K., and Stefanis C.N. Therapy and prevention of affective illness by total sleep deprivation. J. Affect. Disord. 27 (1993) 107-116
77. Papadimitriou G.N., Zervas I.M., and Papakostas Y.G. Unilateral ECT in the prophylaxis of unipolar affective disorder. J. ECT 17 (2001) 229-231
78. Papadimitriou G.N., Papakostas Y.G., Pehlivanidis A.H., and Christodoulou G.N. Non-pharmacological prophylaxis of affective disorders: a current view with clinical observations in case series of depressed patients. Int. J. Psychiatry Clin. Pract. 7 (2003) 93-99
79. Papadimitriou G.N., Dikeos D.G., Calabrese J.R., and Christodoulou G.N. Rapid-cycling bipolar disorder: biology and pathogenesis. Int. J. Neuropsychopharmacol. 8 (2005) 281-292
80. Perry A., Tarrier N., Morriss R., McCarthy E., and Limb K. Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. BMJ 318 (1999) 149-153
81. Petrides G., Dhossche D., Fink M., and Francis A. Continuation ECT: relapse prevention in affective disorders. Convuls. Ther. 10 (1994) 189-194
82. Post R.M., Roy-Byrne P.P., and Uhde T.W. Graphic representation of the life course of illness in patients with affective disorder. Am. J. Psychiatry 145 (1988) 844-848
83. Post R.M., Frye M.A., Denicoff K.D., Leverich G.S., Dunn R.T., Osuch E.A., Speer A.M., Obrocea G., and Jajodia K. Emerging trends in the treatment of rapid cycling bipolar disorder: a selected review. Bipolar Disord. 2 (2000) 305-315
84. Rosenthal N.E., Sack D.A., Carpenter C.J., Parry B.L., Mendelson W.B., and Wehr T.A. Antidepressant effects of light in seasonal affective disorder. Am. J. Psychiatry 142 (1985) 163-170
85. Rusch A.J., George M.S., Sackeim H.A., Marangell L.B., Husain M.M., Giller C., Nahas Z., Haines S., Simpson Jr. R.K., and Goodman R. Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study. Biol. Psychiatry 47 (2000) 276-286
86. Rusch A.J., Marangell L.B., Sackeim H.A., George M.S., Brannan S.K., Davis S.M., Howland R., Kling M.A., Rittberg B.R., Burke W.J., Rapaport M.H., Zajecka J., Nierenberg A.A., Husain M.M., Ginsberg D., and Cooke R.G. Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial. Biol. Psychiatry 58 (2005) 347-354
87. Sachs G.S., and Thase M.E. Bipolar disorder therapeutics: maintenance treatment. Biol. Psychiatry 48 (2000) 573-581
88. Sakkas P., Mihalopoulou P., Mourtzouhou P., Psarros C., Masdrakis V., Politis A., and Christodoulou G.N. Induction of mania by rTMS: report of two cases. Eur. Psychiatr. 18 (2003) 196-198
89. Satterfield J.M. Adjunctive cognitive behavior therapy for rapid-cycling bipolar disorder: an empirical case study. Psychiatry 62 (1999) 357-369
90. Scott J. Cognitive therapy of affective disorders: a review. J. Affect. Disord. 37 (1996) 1-11
91. Scott J., and Gutierez M.J. The current status of psychological treatments in bipolar disorders: a systematic review of relapse prevention. Bipolar Disord. 6 (2004) 498-503
92. Scott J., Garland A., and Moorhead S. A pilot study of cognitive therapy in bipolar disorders. Psychol. Med. 31 (2001) 459-467
93. Schulze-Ranschenbach S.C., Harms U., Schlaepfer T.E., Maier W., Falkai P., and Wagner M. Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression. Br. J. Psychiatry 186 (2005) 410-416
94. The UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 361 (2003) 799-808
95. Tondo L., Hennen J., and Baldessarini R.J. Rapid-cycling bipolar disorder: effects of long-term treatments. Acta Psychiatr. Scand. 108 (2003) 4-14
96. Vanelle J.M., Loo H., Galinowski A., de Carvalho W., Bourdel M.C., Brochier P., Bouvet O., Brochier T., and Olie J.P. Maintenance ECT in intractable manic-depressive disorders. Convuls. Ther. 10 (1994) 195-205
97. Wehr T., and Goodwin F.K. Tricyclics modulate frequency of mood cycles. Chronobiologia 6 (1979) 377-385
98. Wehr T.A., Sack D.A., and Rosenthal N.E. Sleep reduction as a final common pathway in the genesis of mania. Am. J. Psychiatry 144 (1987) 201-204
99. Wehr T.A., Sack D.A., Rosenthal N.E., and Cowdry R.W. Rapid cycling affective disorder: contributing factors and treatment responses in 51 patients. Am. J. Psychiatry 145 (1988) 179-184
100. Wehr T.A., Turner E.H., Shimada J.M., Lowe C.H., Barker C., and Leibenluft E. Treatment of a rapid cycling bipolar patient by using extended bed rest and darkness to stabilize the timing and duration of sleep. Biol. Psychiatry 43 (1998) 822-828
101. Wirz-Justice A., Quinto C., Cajochen C., Werth E., and Hock C. A rapid-cycling bipolar patient treated with long nights, bedrest, and light. Biol. Psychiatry 45 (1999) 1075-1077
102. Wu J.C., and Bunney W.E. The biological basis of an antidepressant response to sleep deprivation and relapse: Review and hypothesis. Am. J. Psychiatry 147 (1990) 14-21
103. Yildiz A., and Sachs G.S. Characteristics of rapid cycling bipolar-I patients in a bipolar speciality clinic. J. Affect. Disord. 79 (2004) 247-251