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2015-12-30T00:00:00.000Z

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Wrong Gary Sachs?

Dr. Gary Sachs S. M.D.

Associate Professor of Psychiatry

Harvard Medical School

Direct Phone: (617) ***-****       

Harvard Medical School

180 Longwood Avenue

Boston, Massachusetts 02115

United States

Company Description

Harvard Medical School has more than 7,500 full-time faculty working in 11 academic departments located at the School's Boston campus or in one of 47 hospital-based clinical departments at 17 Harvard-affiliated teaching hospitals and research institutes. ... more

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Background Information

Affiliations

Board Member
Convio Inc

Scientific Advisory Board
Depression and Bipolar Support Alliance

Fellow
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

Founder
Concordant Rater Systems

Education



University of Maryland Medical School



University of Pennsylvania

M.D.

Harvard Medical School

MA

MD

Harvard University

medical degree

University of Maryland School of Medicine

Web References (197 Total References)


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

www.isbd.org [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.


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

isbd.org [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.


The “Bipolarity Index� | PsychEducation

psycheducation.org [cached]

This system was described in an article by Harvard's Director of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), Dr. Gary Sachs.

...
Dr. Sachs' article indicates that in their experience so far, most Bipolar I patients score above 60. Note that's Bipolar I, not Bipolar II or other more subtle variations, which would presumably have lower scores. Notice that a patient can "get points" for many different features of bipolarity, not just hypomania or mania. In fact, she could get 60 points even without any history of hypomania or mania at all, you see? For example, she might have had: her first depression at age 18 (20 points); post-partum depression (5 points); more than 3 episodes of depression (5 points); agitation while taking an antidepressant (10 points); and have a sister with clear bipolar disorder (20 points).
But beyond this - Bipolar I patients score above 60 - we do not yet know what a particular "score" might mean. Therefore this table is not offered to help you score patients (or yourself). It is presented to demonstrate that some of the most respected mood experts in the world are now using a system which approaches bipolar disorders as existing on a "spectrum", rather than a yes/no, you-have-it-or-you-don't matter. Dr. Sachs himself explains this in an interview conducted shortly after this article, excerpted here.


The Bipolarity Index Interview | PsychEducation

psycheducation.org [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

psycheducation.org [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)

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