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Case Challenge: Clinical Encounters In Mood Disorders, Case 2, A Manic Episode


neuroscienceCME Medical Simulation

Premiere Date: Friday, April 13, 2012

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Pharmacists (ACPE)

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Saturday, April 13, 2013
Note: Credit Is No Longer Available


Roger S. McIntyre, MD, FRCPCRoger S. McIntyre, MD, FRCPC 
University of Toronto
University Health Network
Toronto, ON
Chairman and Executive Director, Brain and Cognition, Depression and Bipolar Support Alliance (DBSA)
Chicago, IL
Clinical Professor, Department of Psychiatry and Neurosciences
University of California School of Medicine
Riverside, CA

Statement of Need

Most general psychiatrists and primary care providers, on a weekly if not daily basis, encounter patients presenting with mood symptoms; mood disorders are among the most common neuropsychiatric disorders. It is estimated that major depressive disorder (MDD) and bipolar disorder (BPD) affect approximately 14.8 million and 5.7 million of adults in the United States aged 18 and over in a given year, respectively. Beyond the sheer number of Americans affected, mood disorders are associated with a significant number of poor outcomes, including disability and death by suicide. Given the impact of mood disorders, clinicians need to be able to assimilate current information from evidence-based clinical guidelines and trials (e.g., STAR*D, STEP-BD) into the care of patients with mood disorders.

This neuroscienceCME Medical Simulation puts the clinician—the life-long learner—in the “driver’s seat” as the decision-maker who is providing care for a patient across two or three clinical encounters. As such, clinicians have the opportunity to put their knowledge into practice with this virtual patient, and then translate their experience to their practice with actual patients.

  • Grunze H, Vieta E, Goodwin GM, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression. World J Biol Psychiatry. 2010;11(2):81-109. PMID: 20148751.
  • Parikh SV, LeBlanc SR, Ovanessian MM. Advancing bipolar disorder: key lessons from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Can J Psychiatry. 2010;55(3):136-143. PMID: 20370963.

    Activity Goal

    To meet specified learning objectives so that clinician knowledge and competence are increased and more clinicians 1) use measurement-based care concepts; 2) diagnose and manage these patients’ comorbid conditions; and 3) use systematic trials to devise individualized therapy regimens for patients with bipolar disorder.

    Learning Objectives

    At the end of this CE activity, participants should be able to:

    • Assess clinical status through routine, systematic use of measurement-based care concepts and rating scales related to BPD.
    • Diagnose and manage neuropsychiatric conditions that are commonly comorbid with bipolar disorder and that require treatment to improve patient outcomes.
    • Tailor an individualized treatment plan for patients with BPD that creates a “best fit” between patient needs and the pharmacologic profiles of evidence-based treatment options.

    Financial Support

    Supported by an educational grant from AstraZeneca LP.

    This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit

    Target Audience

    Physicians, physician assistants, nurses, nurse practitioners, pharmacists, social workers, and certified case managers whose scope of practice includes a high likelihood of clinical encounters with adult patients who have mood symptoms or a diagnosed mood disorder.

    Credit Information

    CME Credit (Physicians):
    CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CME Outfitters designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    CNE Credit (Nurses):
    Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.0 contact hours.

    CPE Credit (Pharmacists):
    ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hours (0.1 CEUs) Universal Activity Number: 0376-0000-12-007-H01-P

    Disclosure Declaration

    It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

    Dr. McIntyre has disclosed that he receives grants/research support from Stanley Medical Research Institute; National Alliance for Research on Schizophrenia and Depression (NARSAD); Eli Lilly and Company; Janssen-Ortho In.; Shire Pharmaceuticals. He serves on the speakers bureaus for Janssen-Ortho Inc.; AstraZeneca Pharmaceuticals, LP; Eli Lilly and Company; H. Lundbeck A/S.; Biovail Pharmaceuticals, Inc.; Wyeth Pharmaceuticals. He serves on the advisory boards of AstraZeneca Pharmaceuticals, LP; Bristol-Myers Squibb Company; France Foundation; GlaxoSmithKline; Janssen-Ortho Inc.; Solvay/Wyeth; Eli Lilly and Company; Organon; H. Lundbeck A/S.; Biovail Pharmaceuticals, Inc.; Pfizer Inc.; Shire Pharmaceuticals; Schering-Plough Corporation.

    Howard Bliwise, MD (content/peer reviewer) has no disclosures to report.

    Ruth Cody, BSN, RN-BC (content/peer reviewer) has no disclosures to report.

    Nancy Jennings, MSN, MBA, MHA, RNC (content/peer reviewer) has no disclosures to report.

    Monique Johnson, MD, CCMEP (planning committee) has no disclosures to report.

    Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

    Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has no disclosures to report.

    Unlabeled Use Disclosure

    Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

    CME Outfitters, LLC, the faculty, AstraZeneca LP, and Lilly USA, LLC do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

    Questions about this activity? Call us at 877.CME.PROS (877.263.7767).


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