Bipolar disorder: how far are we from a rigorous definition and effective management?

摘要: Bipolar disorder is a pathological disturbance of mood, characterized by waxing and waning manic, depressive and, sometimes distinctly mixed states. A diagnosis bipolar can only be made with certainty when the manic syndrome declares itself. Most individuals who are diagnosed this will experience both poles illness recurrently, but episodes commonest cause morbidity indeed, death suicide. Twin, adoption epidemiological studies suggest strongly genetic aetiology. It genetically phenotypically complex disorder. Thus, genes contributing likely to numerous small effect. Individuals also display deficits on range neuropsychological tasks in acute euthymic phases correlations between number affective experienced task performance commonly reported. Current self-report observer-rated scales optimized for unipolar depression hence limited their ability accurately assess depression. The development specific rating scale improve assessment research clinical settings. better treatments interventions. Guidelines support use antidepressants With regard adverse effects depression, double-blind, placebo-controlled data that antidepressant monotherapy or addition tricyclic may worsen course Importantly, adjunctive psychotherapies add significantly (both statistically clinically) efficacy pharmacological treatment regimens. successful management clearly demands improved recognition effective long-term as well mania.