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Chapter 4.1 - Bipolar Disorder

Diagnosis, Clinical Features, Outcome and Treatment

Published online by Cambridge University Press:  04 April 2024

By
Jennifer Burgess ,
Alan Currie ,
Stuart Watson ,
Aditya Sharma ,
David Cousins ,
John Cookson  and
R. Hamish McAllister-Williams
Edited by
David Kingdon ,
Paul Rowlands  and
George Stein
David Kingdon
Affiliation:
University of Southampton
Paul Rowlands
Affiliation:
Derbyshire Healthcare NHS foundation Trust
George Stein
Affiliation:
Emeritus of the Princess Royal University Hospital
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Summary

Bipolar disorder is an affective disorder defined on the basis of the presence of periods of elevated mood. Patients often present with depression, and previous episodes of elevated mood may be missed if not specifically explored during assessment. Bipolar disorder may be difficult to differentiate from other conditions causing mood instability and impulsivity. It is important to identify comorbidities such as substance use, neurodiversity and physical illnesses. The first-line treatment for mania is antipsychotic medication. Antidepressants are reported to have little to no efficacy in treating bipolar depression on average. Lithium is not the only long-term prophylactic agent, but it remains the gold standard, with good evidence that it reduces mood episodes and adverse outcomes. Monitoring is required to ensure lithium level is optimised and potential side-effects minimised.

Keywords

bipolar disorderbipolar spectrummaniadepressionantipsychotic medicationlithiumECTTMSvagal nerve stimulation
Type
Chapter
Information
Seminars in General Adult Psychiatry , pp. 162 - 182
Publisher: Cambridge University Press
Print publication year: 2024

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