Progress in the treatment of bipolar disorder

Progress in the treatment of bipolar disorder Bipolar affective disorder has long been recognized as being one of the most significant causes of increased mortality and morbidity due to mental ill health. Bipolar disorder is an evolution of the older concept of manic-depressive illness, which itself was differentiated from dementia praecox/schizophrenia by Kraepelin over 100 years ago. Bipolar disorder was further differentiated from severe unipolar disorder following research in Europe by Angst and Perris and in the US by Winokur in the 1960s. However, unipolar and bipolar disorders are undeniably closely related, with unipolar disorder being the commonest illness in offspring of bipolar parents. Bipolar disorder has itself been subdivided into bipolar I disorder (with a history of mania) and bipolar II disorder (with a history of hypomania). The recent " Burden of Disease " studies published in the last 10 years which have quantified the amount of years of healthy life lost to all illness show that bipolar affective disorder is one of the leading causes of increased disease burden within mental health, being roughly equal to schizophrenia (Murray and Lopez 1996). Despite the clinical importance of bipolar disorders, they have received relatively less attention both in terms of health care funding and research than other major psychiatric disorders such as schizophrenia and major depression, which of course are themselves under-funded. This has changed somewhat recently due to the advent of novel treatments for the various phases of bipolar disorder. Lithium in its various forms has been used for over 50 years as a recognized medication for the treatment of both mania and depression, and the maintenance of wellness in bipolar disorder. However, after the introduction of lithium there was a long gap before the introduction of other novel treatments such as the anticonvulsants and atypical antipsychotics. Recently, there has been a welcome increase in the literature on the treatment of bipolar disorder. It is therefore very timely that this issue of Neuropsychiatric Disease and Treatment contains three review articles which bring us up to date with various developments in the treatment of bipolar disorders. review treatment options and patient satisfaction in bipolar disorders. Charles Bowden is the principal author of many seminal works on the treatment of bipolar disorder and is particularly associated with the introduction of novel treatments, having authored landmark studies on the efficacy of drugs such as divalproex (with lithium as a comparator) and atypical …