The course of bipolar disorder

Abstract

SummaryBipolar disorder is arguably a pivotal diagnosis in adult psychiatry bounded by schizophrenia on one side and unipolar depression on the other. It represents a wide spectrum of disorders, all sharing common features of elated and depressed mood. The early descriptions of symptom-free euthymia have long been dismissed and the chronic and enduring deficits associated with the disorder are beginning to be better understood. We review the current literature with regard to the course of the disorder, factors that may influence prognosis and common comorbidities.

Subgroups of Adolescent Girls With Borderline Personality Disorder Symptoms

“…The average age of onset of depression in our sample was younger (10yrs) than what is typically reported in community samples. Earlier onset of a psychiatric disorder is generally associated with poorer outcomes, and greater symptom severity and stability (e.g., Hollis, 2000;Saunders, & Goodwin, 2010). It also predicts a higher than average level of dysregulation which reduces the opportunity for normative skill development and increases the risk for a wide range of psychiatric problems as well as engagement in self-injury.…”

Blood pressure monitoring in psychiatric inpatients with bipolar affective disorder

“…14 People with bipolar affective disorder are more likely both to smoke and have hypertension. 10,33 Lifestyle factors, obesity and psychotropic medicines -in particular second-generation antipsychotics -are likely to play a role. 12,34 Furthermore, blood pressure control may be adversely affected by the presence and severity of affective disorders, including bipolar affective disorder -particularly in its acute phase.…”

“…8 Bipolar affective disorder is an episodic illness characterised by periods of depressed and elevated or irritable mood, interspersed with periods of recovery, and affects about 1-2% of people. [8][9][10][11][12] It is increasingly recognised that a significant proportion of people continue to experience residual depressive symptoms in the medium to long term. 11 For the majority, the illness begins in early adulthood (median age of onset 24 years and 27 years respectively for men and women), with the first episode often depressive in nature.…”

“…11 For the majority, the illness begins in early adulthood (median age of onset 24 years and 27 years respectively for men and women), with the first episode often depressive in nature. 8,10 Hypertension, defined as a persistently raised blood pressure, with systolic or diastolic blood pressure measurements above 140mmHg and 90mmHg respectively, 13 is a common and serious medical condition that affects around 30% of adults in England. 14 Its prevalence, however, increases with age, so that over 50% of people aged 55-65 years are affected.…”

Contribution of methotrexate in precipitation of manic episode in bipolar affective disorder explored: a case report

“…The modern conceptualization of this phenomenon as a distinct illness dates back to the 19th century when Falret first described the concept of folie circulaire [Saunders and Goodwin, 2010]. Mania can occur by a chance association during drug treatment, particularly in patients predisposed to mood disorder.…”