Bipolar disorder: a national health concern.
Bipolar disorders are prevalent, disabling, and costly diseases that often pursue an inexorable course. Underdetection, misdiagnosis, and diagnostic delay frequently and unnecessarily interfere with appropriate treatment of the disorder. Mortality studies in bipolar disorder underscore the relevance of both unnatural and natural causes of death, inviting the need for improved preventative and primary health care for bipolar patients. The treatment framework for bipolar disorder must recognize and anticipate the multidimensionality and comorbidity of this illness. Pharmacotherapy is necessary, with multiple concomitant medications required for most patients. In addition, adjunctive psychosocial interventions offer enhanced compliance and may beneficially influence psychopathological and functional outcomes. This article emphasizes the public health concern of bipolar disorder, and provides tactics to enhance detection of cryptic bipolar states, underscore the clinical and pathophysiological relevance of comorbidity in bipolar disorder, and provide a framework for multimodality therapy for this condition.
McIntyre
Roger S
RS
University Health Network, Edith Cavell Wing 3D-003, 399 Bathurst St, M5T 2S8, Ontario, Canada. rmcintyr@uhnres.utoronto.ca
Konarski
Jakub Z
JZ
D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology