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Wrong Gary Sachs?

Dr. Gary S. Sachs

Associate Professor of Psychiatry

Massachusetts General Hospital

Direct Phone: (617) ***-****       

Email: g***@***.edu

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Massachusetts General Hospital

Background Information

Employment History

Founding Director, Bipolar Clinic and Research Program

Massachusetts General Hospital

Principal Investigator


Therapeutic Area Leader



Board Member
The CME Institute

Board Member
Convio Inc

Board Member
Depression and Bipolar Support Alliance

Board Member
Physicians Postgraduate Press Inc

Collaborative Care Initiative, LLC

Scientific Advisory Board
National Alliance on Mental Illness

American Psychiatric Association

Member, Review Board
Journal of Clinical Psychiatry

Member, Review Board
New England Journal of Medicine

Member, Review Board
American Journal of Psychiatry

Board Member
Medscape LLC

Concordant Rater Systems

Advisor Or Consultant
Abbott Laboratories company

Advisor Or Consultant
Eli Lilly and Company

Advisor Or Consultant

Advisor Or Consultant
AstraZeneca PLC

Advisor Or Consultant
Pfizer Inc

Advisor Or Consultant
GlaxoSmithKline plc


University of Maryland Medical School

University of Pennsylvania


Harvard Medical School



Harvard University

medical degree

University of Maryland School of Medicine

Web References (101 Total References)

Depression and Bipolar Support Alliance: Scientific Advisory Board [cached]

Gary Sachs, MD Director, Bipolar Research Program Harvard University

Depression and Bipolar Support Alliance: 2007 Scientific Advisory Board [cached]

Gary Sachs, M.D. Director, Bipolar Research Program Harvard University

The Bipolarity Index Interview | PsychEducation [cached]

This is an important interview with Dr. Gary Sachs, head of the Harvard-associated Mood Disorders Clinic.

To find out, Elizabeth Saenger, PhD, Program Director of Medscape Psychiatry & Mental Health, interviewed Gary Sachs, MD, Director of the Bipolar Mood Program in the Clinical Psychopharmacology Unit, Director of the Harvard Bipolar Research Program, and Assistant Professor of Psychiatry at Massachusetts General Hospital in Boston, Massachusetts.
Dr. Sachs is also principal investigator for the National Institute of Mental Health study on Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).
Medscape: How do you evaluate patients for bipolar disorder?
Dr. Sachs: We certainly use the usual approach of taking a good history of the patient, but one thing that we do differently is approach the diagnostic issue not as a categorical yes-no sort of question, but more as a continuum question, so the issue becomes how much and in what ways is a patient bipolar.[1] What we do is concentrate on how the patient is now. His most extreme episode of mood elevation is our next focal point, and then we'll move systemically through family history, mental status, sexual history, childhood psychiatric illness, all the usual parts.
Dr. Sachs: Yes, and we're not looking to replace the Diagnostic and Statistical Manual with it. What we're trying to do is answer the patient's biggest question, "How likely is it that I have this disorder? And it isn't that we're infallible, either; it's just that we are able to approach it more as a continuous issue, rather than as a black-and-white, yes-no.
Medscape: Do you think that would then decrease the rate of misdiagnosis, which I understand is extremely high with bipolar disorder?
Dr. Sachs: Yes, that's kind of our goal, butit's more the issue of making it clearer to the patients what the diagnosis rests on.
Dr. Sachs: Yes.
Dr. Sachs: What we've found is that most people who have had 2 or 3 episodes of bipolar I will almost always score over 70, so scores over 70 make us pretty confident this is a bipolar I. And, obviously, if somebody is having a first episode and does not have any response to treatment, and doesn't have a course of illness, we can't have a score that's over 60.
Dr. Sachs: That probably isn't the question to ask me, because I'm not a child psychiatrist. But, generally, you see much more dysphoria mixed in. You don't see the distinct episodes, and so there are aspects of bipolar disorder in children that are very controversial, just because they lack those classic features.
Medscape: And is it also true of adolescents, where there's more dysphoria and the episodes are less distinct?
Dr. Sachs: I think by the time you get to adolescence, it's a lot easier for you to distinguish bipolar disorder from other psychiatric problems.
Dr. Sachs: What you're talking about here are 2 different issues.
Dr. Sachs: Yes, back when the Mood Disorder Questionnaire was being validated, Spitzer and William's group also conducted these interviews and they sort of established that 70 is a reasonable cutoff score, given the sensitivity and specificity issues.[2]
Dr. Sachs: Yes.
Dr. Sachs: Well, part of it really does use the pieces from motivational interviewing to perhaps get there, and we really try to be good negotiators, not in the sense of getting people to adopt our positions, but to work to establish external criteria to judge these measurements, so we can have an iterative approach to treatment.
Dr. Sachs: We really do.
Dr. Sachs: Well, the patients initially are given a shot at doing it themselves.
Disclosure: Gary Sachs, MD, has disclosed that he owns stock, stock options, or bonds in Concordant Rater Systems, LLC, and has received grants for educational activities from GlaxoSmithKline, AstraZeneca, Wyeth, Eli Lilly, Sanofi, and Abbott Laboratories. Dr. Sachs has also disclosed the he served as advisor or consultant for GlaxoSmithKline, Pfizer, AstraZeneca, Wyeth, Eli Lilly, Sanofi, and Abbott Laboratories.

What’s New? | PsychEducation [cached]

A new diagnostic approach based on "scoring" bipolar symptoms and other signs of bipolarity has been published by Dr. Gary Sachs, describing the system now in use at Harvard. A new page describing their system has been linked to the main Diagnosis pages. (June 2005) Updated the "Bipolar Hypothesis" re: FDA warnings of suicidal thinking following antidepressants with two articles that make the same case. (June 2005) Minor additions to the Fish Oil pages: Fish burps with omega-3's reduced by freezer storage, some say; and no PCB's found in 5 different capsule types (May 2005) Medscape did a great interview with Gary Sachs, the head of the Harvard Bipolar Clinic: here is a link and a few excerpts. (May 2005) Added a nifty drug-interaction website to the Select Sites page. (May 2005)

Upcoming Advocacy Activities - The International Society for Bipolar Disorders (ISBD) [cached]

The concordance concept:An analogy proffered by DBSA Scientific Advisory Board member and ISBD member Gary Sachs, MD, Professor of Psychiatry at Harvard Medical School and Director of the Bipolar Mood Disorder Program at Massachusetts General Hospital, is that of a ship where the patient is the captain and the provider is the navigator. The captain-or consumer-makes the decisions and lives with the far-reaching consequences, while his chief partner the navigator-or clinician-has vital, specialized skills that, if ignored, can result in a potentially devastating crash. When the navigator's guidelines are understood, agreed upon, and followed by the captain, the sailing can be smooth.

Dr. Sachs's word for the smooth sailing of such treatment is "concordance," an inherently more mutual and empowering concept than "adherence" or, certainly, "compliance.

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