Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ


Posted by ratgrrl on October 15, 2003, at 9:42:46

In reply to Re: how can you tell when your psych is over involved?, posted by ratgrrl on October 14, 2003, at 16:54:39

Here are the references re: the "kindling hypothesis" as promised

The article that I read in full is by Mark Hyman Rapaport, MD and Deborah J. Hales, M.D. and is called
"Relapse Prevention and Bipolar Disorder: a focus on Bipolar Depression" from the Journal FOCUS: the jounal of lifelong learning in psychiatry, in the Winter 2003, Vol 1, No. 1 issue, pages 15-31

I will quote the paragraphs that discuss the "kindling hypothesis"

Post et al. proposed that bipolar disorder may be subject to a kindling-like phenomenon (9). The kindling hypothesis postulates that the course of biplar disorder generally shows increasingly shorter periods of remission between episodes of illness, with later episodes more independent of environmental precipitation. This model postulates that patients become sensitized to very minor stressors, with play an increasing role in precipitating the onset of new episodes. For example, subsyndromal symptoms will increase the risk of disease recurrence (10). Post and colleagues suggested that treatment with mood stabilizers may favorably affect the course of the bipolar disorder by reducing the kindling phenomena.

However, not all studies are supportive of the kindling hypothesis; a 10-year naturalistic follow-up study by Winokur et al. found that some patients, even patients with rapid cycling, experienced less frequent mood episodes over time (11). A recent analysis of the longitudinal bipolar data set from Western Psychiatric Institute and Clinic did non show that sensitization occurred as the number of episodes increased, nor do these data support the observation that the interepisode time decreased significantly in patients with bipolar disorder (12). Although these studies do not support the kindling hypothesis, authors agree with the assertion that continuation of treatment is reasonable for most patients with bipolar disorder."

So what was all that mumbo jumbo? It was just saying that despite what most doctors (at least most of my doctors) present as fact: that if left untreated bipolar gets worse and worse and thus if you ever go off treatment, you will be worse than you were before, and might become untreatable, there is definitely not consensus on this fact. Note however, that even the people who don't support the kindling hypotheis, do support treatment with mood stabilizers. They are not saying the disease cures itself with time, they are only saying it may not get worse.

The numbers in the paragraphs referred to the actual studies discussed. They are as follows:

(9) Post RM, Rubinow DR, Ballenger JC; Conditioning, sensitizationand kindling: implications for the course of affective illness, in Neurobiology of Mood Disorders. Edited by Post RM, Ballenger JC, Baltimore, Williams and Wilkins, 1984; 56:5-13
(10) Solomon DA, Keitner GI, Miller IW, Shea MT, Keller MD; Course of illness and maintenance treatments for patients with bipolar disorder. J Clin Psychiatry 1995; 56:5-13
(11) Winokur G, coryell W, Akiskal HS, Endicott J, Keller M, Mueller T; Manic-depressive (bipolar) disorder: the course in light of a prospective ten-year follow-up of 131 patients. Acta Psychiatr Scand 1994: 89:102-110
(12) Hlastala SA, Frank E, Kowalski J, Sherrill JT, Tu XM, anderson B, Kupfer DJ; Stressful life events, bipolar disorder, and the "kindling model" J Abnorm Psychology 2000; 109:777-786

If anyone needs help deciphering the references, let me know.





Post a new follow-up

Your message only Include above post

Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.


Start a new thread

Google www
Search options and examples
[amazon] for

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:ratgrrl thread:269101