Units which specialise in the treatment of affective (mood) disorders are gaining popularity in Australia and overseas. This paper examines the history, role and function of these units with particular reference to their benefits and disadvantages. Specialised units can offer advantages in the assessment and management of depression and bipolar illness, as well as being centres for research and education. Further research into their effectiveness is needed to enable their rational integration into existing psychiatric services.
References
1.
GershonS. University of Pittsburgh: Personal Communication.
2.
GitlinG. Lithium Clinics: Clinical practices. In: JamisonKR ed. Lithium: Clinical Considerations. Proceedings of a symposium. Excerpta Medica Amersterdam: UCLA School of Medicine, February 2, 1982.
3.
KerryRJ. A special lithium clinic. Diseases of the Nervous System1968; 30: 490–492.
4.
JarrettDBBurrowsGDDaviesB. Lithium as a prophylactic agent in recurring affective disorders. Medical Journal of Australia1973; 1: 325–328.
5.
Directory of Lithium Clinics 1978, Smith Kline and French.
6.
CoppenA. Everyday Management of Affective Disorders. Lancet April 1987; 866.
7.
PooleAJJamesHDHughesWC. Treatment experiences in the lithium clinic at St. Thomas' Hospital. Journal of the Royal Society of Medicine1978; 71: 890–894.
8.
WolfRSimhandlChThauK. Routine and course documentation of the lithium outpatient clinic. In: BirchNJ ed. Lithium: inorganic pharmacology and psychiatric use. Oxford: IRL Press.
9.
PietzckerAMuller-OerlinghausenB. The outpatient clinic for patients under chronic lithium or neuroleptic treatment as a phase IV research tool. Pharmacopsychiatry1984; 17: 162–167.
BurrowsGD, University of Melbourne: Personal communications.
13.
BrodatyHBoycePWilhelmK. The establishment of a mood disorders unit. Australian and New Zealand Journal of Psychiatry1987; 21: 375–381.
14.
JohnsonG, University of Sydney: Personal Communication.
15.
GitlinMJJamisonKR. Lithium clinics: theory and practice. Hospital and Community Psychiatry1984; 35: 363–368.
16.
WeissmanMMLeafPJTischlerGL. Affective disorders in five United States communities. Psychological Medicine1988; 18: 141–153.
17.
WeissmanMMLeafPJBruceMLFlorioL. The epidemiology of dysthymia in five communities: rates, risks, comorbidity, and treatment. American Journal of Psychiatry1988; 145; 7: 815–819.
18.
RegierDAHirschfeldRMAGoodwinFK. The NIMH depression awareness, recognition and treatment programme: structure, aims and scientific basis. American Journal of Psychiatry1988; 145; 11: 1351–1357.
19.
KlermanGL. The current age of youthful melancholia. British Journal of Psychiatry1988; 152: 4–14.
20.
KlermanGLWeissmanMM. Increasing rates of depression. Journal of the American Medical Association1989; 261: 2229–2235.
21.
HagnellOLankeIRorsmanBOjesjoL. Are we entering an age of melancholy? Depressive illness in a prospective epidemiological study over 25 years: the Lundby Study, Sweden. Psychological Medicine. 1982; 12: 279–289.
22.
WeissmanMMKlermanGL. The chronic depressive in the community: unrecognised and poorly treated. Comprehensive Psychiatry1977; 18: 523–531.
23.
WeissmanMMMyersJKThompsonWD. Depression and its treatment in a US urban community-1975–1976. Archives of General Psychiatry. 1981; 38: 417–421.
24.
KellerMBKlermanGLLavoriPW. Treatment received by depressed patients. Journal of the American Medical Association1982; 248: 1848–1855.
25.
MacEwanGWRemickRA. Treatment resistant depression: a clinical perspective. Canadian Journal of Psychiatry1988; 33: 788–792.
26.
ScottJ. Chronic depression. British Journal of Psychiatry1988; 153: 287–297.
27.
FieveR. The lithium clinic: a new model for the delivery of psychiatric services. American Journal of Psychiatry1975; 132: 1018–1022.
28.
FieveR. Lithium affective disorder clinics. In: van PraagHMLaderMHRafaelsenOJSacharEJ, eds. Handbook of biological psychiatry, Part VI, practical applications of psychotropic drugs and other biological treatments. New York: Marcel Decker, 1981: 135–148.
29.
FieveR. Lithium and manic-depressive disorders. In: CanceroShapiroKesselman eds. Progress in the functional psychoses. New York: SP Medical and Scientific Books, 1979; 161–176.
30.
FieveRPeselowE. The lithium clinic: In: JohnsonFN ed. Depression and mania: modern lithium therapy. Washington DC: IRL Press, Oxford1987: 127–129.
31.
FieveR. The lithium clinic for treatment and prevention of manic depression: a cost benefit approach. Egyptian Journal of Psychiatry1979; 2: 166–190.
32.
SchouM. Lecture, 1989, American Psychiatric Association Annual Congress, San Francisco (personal communication).
33.
SchouM. The integrated approach: on the significance of pharmacological and nonpharmacological factors when lithium prophylaxis fails. Acta Psychiatrica Scandinavica1988; Supplement 345, 78: 119–123.
34.
HayesRC. Developing a group programme for the treatment of outpatients on lithium carbonate. Hospital and Community Psychiatry1976; 27: 391–392.
35.
BeyRChapmanRETornquistRN. A lithium clinic. American Journal of Psychiatry1972; 129: 468–470.
36.
PapolosDFPapolosJ. Overcoming depression. New York: Harper and Row1987: 153–163.
37.
FoelkerGAMolinariVMarmionJJChackoRC. Lithium groups and elderly bipolar patients. Clinical Gerontologist1986; 5: 297–308.
38.
Abou-SalehMTCoppenAJ. Acute treatment, long-term management and prophylaxis of affective disorders. Psychiatric Annals1987; 17: 301–303, 307–308.
39.
MastertonGWarnerMRoxburghB. A comparison of a lithium clinic, psychiatric outpatient clinics, and general practice. British Journal of Psychiatry1988; 152: 535–538.
40.
VestergaardMSchouM. Prospective studies on a lithium cohort: 1. General features, Acta Psychiatrica Scandinavica1988; 78: 421–426.
41.
VolkJMuller-OerlinghausenB. Time course of AMP-documented side-effects in patients under long-term lithium treatment. Pharmacopsychiatry1986; 19: 286–287.
42.
PowellBJOthmerESinkhornC. Pharmacological aftercare for homogenous groups of patients. Hospital and Community Psychiatry1977; 28: 125–127.
43.
EllenbergJSalamonIMeaneyC. A lithium clinic in a community mental health centre. Hospital and Community Psychialry1980; 31: 834–836.
44.
PeselowEDFieveR. Cost effectiveness of a lithium clinic. In: JohnsonFN ed. Depression and mania: modern lithium therapy. Washington DC: IRL Press. Oxford1987: 259–261.
45.
CusanoPPMayoO'Connell RA. The medical economics of lithium treatment for manic-depressives. Hospital and Community Psychiatry1977; 28: 169–173.
46.
DalyRM. Lithium-responsive affective disorders: model comprehensive plan for treatment. New York State Journal of Medicine1978; March: 594–601.