The need for specialist services for serious and recurrent mood disorders.

Australian & New Zealand Journal of Psychiatry, 48(6) gambling debts, lying, criminal activity in order to obtain money and the avoidance of paying debts. Additionally, the patient complained of decreased mood with suicidal thoughts, increased psychomotor drive and sleep disturbances. A thorough psychiatric assessment of the patient revealed that during puberty the patient had become hyperactive and had problems maintaining concentration. In adulthood, the patient developed depressive and coexisting manic symptoms during the same mood episodes. In addition, the patient’s grandfather had had a manic episode in the past. Bipolar disorder was diagnosed, currently mixed episodes. The patient was commenced on lamotrigine 150 mg/day and aripiprazole 15 mg/day. After 8 weeks of treatment, psychomotor drive and mood were stabilized, concentration span was increased and sleep disturbances disappeared. However, obsessive thoughts about gambling activities were still observed, so the patient was commenced on cognitive-behavioural therapy. After another 8 weeks of treatment, obsessive thoughts and compulsive activities connected with gambling were less severe and the patient’s mood stabilized. This case report reveals the necessity for the verification of a mood disorder diagnosis. A medical history that includes a thorough investigation of a patient’s past behaviours is extremely important in order to make the right diagnosis and for proper drug treatment. The use of lamotrigine and aripiprazole in combination for the treatment of mixed episode of bipolar disorder was effective in this case. Funding