Educational attainment in the United States Income differences between the varying levels of educational attainment usually measured by the highest degree of education an individual has completed have increased. Expertise and skill certified through an academic degree translates into increased scarcity of an individual's occupational qualification which in turn leads to greater economic rewards. Households in the upper quintiles are generally home to more, better educated and employed working income earners, than those in lower quintiles.
More information 1 Recommendations The following guidance is based on the best available evidence. The full guideline gives details of the methods and the evidence used to develop the guidance.
Treatment and support for specific populations 1. See the NICE clinical guidelines on antisocial personality disorderborderline personality disorderattention deficit hyperactivity disordergeneralised anxiety disorder and psychosis with coexisting substance misusebe alert to the potential for drug interactions and use clinical judgement.
Information and support 1. If the person with bipolar disorder agrees, this could include talking directly with education staff, creditors and employers about bipolar disorder and its possible effects, and how the person can be supported.
Support for carers of people with bipolar disorder 1. Develop a care plan to address any identified needs, give a copy to the carer and their GP and ensure it is reviewed annually [ 9 ]. When providing information, offer the carer support if necessary[ 9 ]. Foster a collaborative approach that supports both people with bipolar disorder and their carers, and respects their individual needs and interdependence[ 9 ].
Managing bipolar disorder in primary care 1. Discuss with the person the possible benefits and risks of psychological interventions and their preference.
Monitor mood and if there are signs of hypomania or deterioration of the depressive symptoms, liaise with or refer the person to secondary care. If the person develops mania or severe depression, refer them urgently to secondary care.
Monitoring physical health 1. A copy of the results should be sent to the care coordinator and psychiatrist, and put in the secondary care records[ 9 ].
Give the person and their GP a copy of the plan, and encourage the person to share it with their carers [ 9 ]. Give the person and their GP a copy of the plan, and encourage the person to share it with their carers. Advise them not to make important decisions until they have recovered from mania or hypomania and encourage them to maintain their relationships with their carers if possible.
Reviewing treatment for mania 1. Monitor mood for signs of mania or hypomania or deterioration of the depressive symptoms.
If the person prefers, consider either olanzapine without fluoxetine or lamotrigine [ 15 ] on its own. If there is no response to fluoxetine combined with olanzapine, or quetiapine, consider lamotrigine on its own.A.
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