$3.7 million program targets Hispanics with bipolar disorder

To personalize care, team studies factors affecting Mexican Americans

SAN ANTONIO (Nov. 7, 2011) — Mental health professionals with UT Medicine San Antonio and collaborating institutions are designing bipolar disorder treatments that will be relevant and culturally sensitive to Hispanics, thanks to a $3.7 million grant from the National Institutes of Health. Three research programs will target Mexican Americans, who represent the majority of U.S. Hispanics.

UT Medicine is the clinical practice of the School of Medicine at The University of Texas Health Science Center San Antonio.

“We will test for specific cultural factors that affect the response and engagement of Hispanics who have bipolar disorder,” said the study principal investigator, Charles L. Bowden, M.D. Dr. Bowden leads a large group of experienced psychiatrists, psychologists and other scientists who will conduct the comprehensive program of research over the next five years.

Shifts in mood and energy
Bipolar disorder, the sixth leading cause of disability worldwide, is a chronic condition characterized by rapid mood swings. According to the National Institute of Mental Health (NIMH), bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks. These shifts in mood and energy levels are more severe than the normal ups and downs that are experienced by everyone.

Annual prevalence of bipolar disorder among American adults is 2.6 percent, according to the NIMH. Prevalence of childhood-onset bipolar disorder is not well established.

Eliminating trial and error
The National Institutes of Health provided an Advanced Center award that is the first ever made for bipolar disorder research. One of the studies will test a novel design that has the potential to provide much more practical information to clinicians. “This will aid clinicians in selecting specific treatments most likely to help an individual patient, rather than resorting to a trial-and-error approach that is currently often applied,” Dr. Bowden said.

Investigators will assess participants’ acceptance of treatment, their perception of side effects and their awareness of the illness. Innovative and culturally sensitive treatment approaches will be explored. “The goal is to optimize treatment outcomes of bipolar disorder by considering characteristics of the communities in which people live,” Dr. Bowden said.

Patients’ stories
Two investigators will address the personal experiences of study participants. This will provide a biographical sense of the challenges that confront these patients in relationship to bipolar disorder and its impacts on their lives, families and community experience.

One of these investigators, Bryan Bayles, Ph.D., is a cultural anthropologist, and the other, John Phillip Santos, is a nationally acclaimed writer on Hispanic migration to the U.S. Santos is a San Antonio native and faculty member of The University of Texas at San Antonio.

The research program involves collaborative work with the Center for Health Care Services, which is the primary organization charged with treatment programs for medically indigent persons with severe mental disorders in Bexar County, and the bipolar disorder research programs at the Texas Tech University Health Sciences Center at El Paso and Case Western Reserve University School of Medicine in Cleveland, Ohio.

Mauricio Tohen, M.D., Dr.P.H., M.B.A., a native of Mexico, is associate director of the overall program, which is titled “Optimizing Outcomes in Bipolar Illness Interventions in Hispanic Communities.” Jim Mintz, Ph.D., M.S., leads the statistical unit, and Vivek Singh, M.D., M.P.H., and Jodi Gonzalez, Ph.D., M.S., lead the major treatment studies.

Dr. Bowden recently was the sole North American author on a large international study that showed bipolar disorder features were more frequent in patients with major depressive episodes than indicated by existing criteria used by psychiatrists. (see release below)


This work was supported in part by a grant from the National Institutes of Health, National Institute of Mental Health, 1P30 MH086045, to Charles L. Bowden, M.D., principal investigator.

UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center at San Antonio. With more than 700 doctors – all faculty from the School of Medicine – UT Medicine is the largest medical practice in Central and South Texas, with expertise in more than 60 different branches of medicine. Primary care doctors and specialists see patients in private practice at UT Medicine’s clinical home, the Medical Arts & Research Center (MARC), located in the South Texas Medical Center at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and there are clinics and physicians at several local and regional hospitals, including CHRISTUS Santa Rosa, University Hospital and Baptist Medical Center. Call (210) 450-9000 to schedule an appointment, or visit the Web site at www.UTMedicine.org for a complete listing of clinics and phone numbers.

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