Bipolar Disorder

Basics

Mood disorder characterized by recurrent episodes of mania, hypomania, or depression
Characterized by episodes of altered mood, but psychotic features present even when mood is normal
Bipolar I Disorder: At least 1 manic episode, with or without depressive or hypomanic episodes.
Bipolar II Disorder: At least 1 hypomanic and 1 major depressive episode, without manic episodes
Mixed episode:
- Simultaneous symptoms of mania and depression
- Defined as one or more manic episodes
Cyclothymia is a syndrome of less severe episodes of hypomania and depression over years
Atypical and residual forms: manifestations that do not fit standard diagnostic criteria
Bipolar disorder affects over 1% of the global population
Lifetime prevalence: 0.6% bipolar I, 0.4% bipolar II.
Typically begins in the teens or 20s
Earlier-onset linked to greater comorbidities, depressive onset
Diagnosis often delayed by 5 yr from symptom onset

Genetically complex with multifactorial genesis
Heritability estimated up to 85%
May be secondary to medical disorder (eg, drug toxicity, endocrine, neurologic process)
Medications can trigger or reveal bipolar-like symptoms:
- Classically mania after initiation of an antidepressant

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