Citation

Clark R, Chambers S. Drugs Context 2007; 3(1).

Copyright

(Copyright © 2007, Bioexcel Publishing)

DOI

10.7573/dic.212206

PMID

unavailable

Abstract

Bipolar disorder is a serious, recurrent disabling psychiatric illness characterised by episodes of mania and depression. The two major types of bipolar disorder (type I and type II), differ in the severity and duration of symptoms, and have a combined prevalence of approximately 1-2%, imposing an annual cost to the UK economy of about £2 billion. Other classifications of bipolar disorder include mixed episodes of mania and depression or rapid cycling between mania and depression. Bipolar disorder is a leading worldwide cause of disability and is associated with a particulary high risk of suicide. Other psychiatric disorders such as anxiety and substance abuse are also frequently comorbid with bipolar disorder. Misdiagnosis is common because of the variable presentation of the disorder. For example, if depressive episodes are the first symptoms manifested, patients are often mistakenly diagnosed with unipolar depression. Treatment of such patients with antidepressants, particularly in the absence of a mood stabiliser, can precipitate manic episodes. Moreover, in more chronic cases treatment with antidepressants alone may result in the development of the more serious and difficult-to-treat, rapid-cycling disorder. Thus, it is vitally important that physicians working in primary care recognise potential cases of bipolar disorder and use short screening questionnaires if bipolar disorder is suspected. Recent guidelines published by the National Institute for Health and Clinical Excellence (NICE) highlight the need for better recognition of bipolar disorder in the community allied with a reduction in suboptimal care in order to substantially improve the outcomes of affected patients.

Language: en