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California Psychiatric Association
Legislative Priorities for 1999
AB 88 Literature

COMPARISON OF THREE CHRONIC DISEASES
WITH A CLEAR COMBINATION OF BIOLOGY AND BEHAVIOR

Disease	Bipolar Disorder (Manic Depression)	Arteriosclerosis	Diabetes
Organ	Brain	Heart	Pancreas
System	Central Nervous	Circulatory	Digestive
Onset	Active disease frequently starts with a triggering event for persons with genetic predisposition.
Diagnosis & Supervision of treatment	By Physician	By Physician	By Physician
Typical Medications:	Lithium, Valproic Acid (Depakote)	Beta Blockers	Insulin, Orinase
Behavioral Changes Needed:	All three require the patient to overcome denial, recognize and acknowledge the illness and develop insight into the condition, as well as compliance with the medications prescribed.
Behavioral Changes Needed:	Lessen life stresses that produce destabilization of mood.	Diet, exercise, weight control, no smoking, Lessen stress	Diet, exercise, weight control
Monitoring Needed:	All three require medication monitoring for effectiveness, side effects, and interaction with the patient's other medications and illness.
Typical Insurance Coverage	0 to 50% hospital Dr. visits 0 to 50%	80 - 100% Hospital Dr. visits 80%	80 - 100% Hospital Dr. visits 80%
Diagnostic Stds & Process	All three illness are diagnosed using detailed manuals that articulate standards and criteria for diagnosis, physical examinations, medical history.
Allied Health Professionals who help in behavioral change	MFCC, psychologist LCSW, clergy, health counselor	dietitian, nurse, health counselor	nurse, dietitian, health counselor
Prognosis for "normal" life with proper care	Good	Fair to good	Good
Medical Treatment Effectiveness	85 - 90%	43%	Variable
Cost Effectiveness	Excellent	Moderate	Excellent
Genetic Predisposition	Yes	Yes	Yes

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