Diagnostic Features, Prevalence, and Impact of Bipolar Disorder

Bipolar Disorders Clinic, Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, California, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 06/2010; 71(6):e14. DOI: 10.4088/JCP.8125tx11c
Source: PubMed


Bipolar disorder shares depressive symptoms with unipolar major depressive disorder but is defined by episodes of mania or hypomania. Bipolar disorder in its broadest sense has a community lifetime prevalence of 4% and is a severely impairing illness that impacts several aspects of patients' lives. Race, ethnicity, and gender have no effect on prevalence rates, but women are more likely to experience rapid cycling, mixed states, depressive episodes, and bipolar II disorder than men. Patients with bipolar disorder have high rates of disability and higher rates of mortality than individuals without bipolar disorder. Natural causes such as cardiovascular disease and diabetes, as well as suicide and other "unnatural" causes are key contributors to the high mortality rate. The costs associated with bipolar disorder include not only the direct costs of treatment, but also the much greater indirect costs of decreased productivity, excess unemployment, and excess mortality.

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    • "Bipolar disorder is a common disabling illness characterized by a recurrent and episodic course involving disturbances of mood, sleep, behaviour, perception, and cognition (Goodwin and Jamison, 2007), with a lifetime morbid risk of approximately 4% (Ketter, 2010). It is estimated that 30–50% of largely remitted bipolar patients fail to attain premorbid levels of psychosocial functioning and much of this disability may be linked to cognitive impairment (Goodwin and Jamison, 1990). "
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    ABSTRACT: Neuropsychological deficits constitute enduring trait-like features in bipolar disorder (BD), and persist in euthymia. White matter (WM) abnormalities are one of the most consistently reported findings in neuroimaging studies of BD. We hypothesized that neuropsychological performances could correlate with WM integrity in a sample of bipolar patients in core WM tracts. Seventy-eight patients affected by BD were evaluated for verbal memory, working memory, psychomotor coordination, executive functions, attention and information processing, and verbal fluency through the Brief Assessment of Cognition in Schizophrenia. White matter integrity was evaluated using DTI and tract-based spatial statistics with threshold free cluster enhancement (p>0.949). We observed that cognitive performances in attention and information processing, working memory, executive functions and psychomotor coordination were associated with DTI measures of WM integrity in several association fibres: inferior and superior longitudinal fasciculus, inferior fronto-occipital fasciculus, cingulum bundle, corpus callosum, and corona radiata. The drug treatments administered during the course of the illness could have influenced DTI measures and neurocognitive function. Other limitations include issues such as generalizability due to the lack of a control group, possible undetected past comorbidities, population stratification, and the presence of a 28% of patients which previously experienced delusions. This is the first study to use a validated cognitive battery to investigate the principal cognitive domains in BD. Our data confirm the importance of WM integrity as a neurobiological underpinning of cognitive deficits. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 12/2014; 174C:342-352. DOI:10.1016/j.jad.2014.12.030 · 3.38 Impact Factor
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    • "In addition, there is evidence of a mounting epidemic of mental disorders in the last 15 years. In fact, childhood bipolar disorder increased 40- fold (Moreno et al., 2007), autism increased by 20-fold, attention deficit hyperactivity disorder (ADHD) has tripled (Bloom et al., 2011), and adult bipolar disorder doubled (Ketter, 2010). These data add more confusion about the efficacy of the DSM in delineating " normality " from " pathology " as some of these statistics suggest that almost all of the population has mental disorders. "
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    ABSTRACT: In this paper we review the Diagnostic and Statistical Manual of mental health (DSM), its scientific bases and utility. The concepts of "normality," "pathology," and boundaries between them are critically reviewed. We further use the concepts of mindfulness and mindlessness, and evidence from cognitive and social sciences to investigate the DSM clinical and social impact and we argue against its assigned overpower. We recommend including alternative perspectives to the DSM, such as mindfulness and positive psychology. We also argue for including mindfulness training in psychiatric residency and clinical psychology programs.
    Frontiers in Psychology 06/2014; 5:602. DOI:10.3389/fpsyg.2014.00602 · 2.80 Impact Factor
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    • "Bipolar disorder is associated with a high rate of morbidity, disability [1] , and comorbid anxiety and drug abuse [2] , and has a major effect on social and occupational devel- opment [3] [4] . The average onset age of bipolar disorder is between 20 and 40 years, while the lifetime prevalence ranges from 0.5% to 1.5%, with equal occurrence in women and men [5] [6] . Because of its early onset and chronicity, bipolar disorder is one of the top thirty causes of worldwide disability [7] [8] . "
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    ABSTRACT: To examine the efficacy and safety of short-term and long-term use of antidepressants in the treatment of bipolar disorder.
    Neural Regeneration Research 11/2013; 8(31):2962-74. DOI:10.3969/j.issn.1673-5374.2013.31.009 · 0.22 Impact Factor
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