Bipolar disorder in adults - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Bipolar disorder is a recurrent and often chronic mental illness marked by episodes of hypomania or mania and depression, associated with a change or impairment in functioning. It is associated with a reduction in life expectancy of around 10-20 years (primarily attributable to cardiovascular disease and suicide).
The long-term course of illness is characterized by a predominance of depression, although a history of at least one manic, hypomanic, or mixed episode is required to make the diagnosis of bipolar disorder.
Diagnosis is based on a comprehensive clinical assessment, encompassing the mental status exam at the time of the evaluation and the longitudinal history from the patient and family, using diagnostic criteria for bipolar disorder.
Misdiagnosis and delayed diagnosis of bipolar disorder are common, with depressive disorders, including unipolar major depressive disorder, accounting for the most frequent diagnostic errors.
The management of acute mania, as well as maintenance treatment, requires mood stabilizers or antipsychotics, as monotherapy or in combination. There are fewer approved treatment options for acute bipolar depression; traditional antidepressants alone are not indicated.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

FDA-approved medications for bipolar disorder

Citations

Key Articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed, text revision (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022.[Full Text]
Yatham LN, Chakrabarty T, Bond DJ, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations. Bipolar Disord. 2021 Dec;23(8):767-88.[Abstract]
Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018 Mar;20(2):97-170.[Abstract][Full Text]
National Institute for Health and Care Excellence. Bipolar disorder: assessment and management. Dec 2023 [internet publication].[Full Text]
Goodwin GM, Haddad PM, Ferrier IN, et al. Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2016 Jun;30(6):495-553.[Abstract][Full Text]
Fountoulakis KN, Grunze H, Vieta E, et al. The International College of Neuro-Psychopharmacology (CINP) treatment guidelines for bipolar disorder in adults (CINP-BD-2017), Part 3: the clinical guidelines. Int J Neuropsychopharmacol. 2017 Feb 1;20(2):180-95.[Abstract][Full Text]

Other Online Resources

Rapid Mood Screener (RMS)
Mood Disorder Questionnaire (MDQ)
Bipolarity Index
Young Mania Rating Scale
Rapid Mood Screener (RMS)
Drugs and Lactation Database (LactMed®)
MotherToBaby
National Institute of Mental Health: bipolar disorder
Depression and Bipolar Support Alliance
European Medicines Agency: valproate medicines pregnancy prevention programme materials

Referenced Articles

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