BIPOLAR DISORDER - 02/09/11
Résumé |
Bipolar disorder (manic-depressive illness) is a common, recurrent, and severe psychiatric illness.20 Classified as a mood disorder, this illness also affects cognition and behavior and frequently is complicated by psychotic symptoms (e.g., delusions, hallucinations, disorganized thinking).47 Untreated, bipolar disorder is associated with substantial risks of morbidity and mortality. Bipolar disorder was the sixth leading cause of disability worldwide in 1990.49 Morbidity resulting from the illness is not limited to acute episodes of mania or depression. Full recovery of functioning often lags behind remission of symptoms.35, 66 Recurrent episodes may cause progressive deterioration in functioning between episodes, and the number of episodes may have a negative impact on subsequent prognosis. Bipolar disorder can be a lethal illness. At least 25% of patients attempt suicide, and patients with mixed mania (cooccurring manic and depressive episodes) appear to be at greater risk for contemplating suicide.15, 20, 69
Bipolar disorder is a highly heritable biologic illness. Concordance rates for bipolar disorder in monozygotic twins are approximately 65% to 70% and approximately 14% for dizygotic twins.22 In family studies, the lifetime prevalence rates of mood disorders (major depressive disorder and bipolar disorder) among first-degree relatives of bipolar probands are increased compared with the prevalence rates for these disorders in first-degree relatives of people without psychiatric illness.22 The mode of inheritance of bipolar disorder is unknown, however. The impact of life stresses, especially early in the course of illness, also remains uncertain.54 In clinical practice, a family history of a mood disorder, particularly bipolar disorder, is important corroborative evidence of the presence of a mood disorder in a patient presenting with psychotic symptoms.25
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| Address reprint requests to Paul E. Keck, Jr, MD, Department of Psychiatry, University of Cincinnati College of Medicine, ML 559 231 Albert Sabin Way, Cincinnati, OH 45267 Supported in part by a grant from the Theodore and Vada Stanley Foundation, a program of the NAMI Research Institute. |
Vol 85 - N° 3
P. 645-661 - mai 2001 Retour au numéro
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- DEPRESSION AND DYSTHYMIA
- J. David Moore, Joseph R. Bona
- SCHIZOPHRENIA
- Donald C. Goff, Stephan Heckers, Oliver Freudenreich
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