BIPOLAR DISORDER - 02/09/11

Doi : 10.1016/S0025-7125(05)70334-5

Paul E. Keck, MD ^a, Susan L. McElroy, MD ^a, Lesley M. Arnold, MD ^a,^b
^a Department of Psychiatry, Biological Psychiatry Program (PEK, SLM, LMA)
^b Women's Health Research Program (LMA), University of Cincinnati College of Medicine, Cincinnati, Ohio

Resumen

Bipolar disorder (manic-depressive illness) is a common, recurrent, and severe psychiatric illness.^{20Goodwin F.K., Jamison K.R. Manic-Depressive Illness New York: Oxford University Press (1990).

Haga clic aquí para ir a la sección de Referencias} 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).^{47McElroy S.L., Keck P.E., Strakowski S.M. Mania, psychosis, and antipsychotics J Clin Psychiatry 1996 ; 57 : 14-26

Haga clic aquí para ir a la sección de Referencias} Untreated, bipolar disorder is associated with substantial risks of morbidity and mortality. Bipolar disorder was the sixth leading cause of disability worldwide in 1990.^{49Murray C.J.L., Lopez A.D. The Global Burden of Disease: Summary Cambridge, MA: Harvard School of Public Health (1996).

Haga clic aquí para ir a la sección de Referencias} 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.^{35Keck P.E., McElroy S.L., Strakowski S.M., y al. Twelve-month outcome of bipolar patients following hospitalization for a manic or mixed episode Am J Psychiatry 1998 ; 155 : 646-652

Haga clic aquí para ir a la sección de Referencias, 66Strakowski S.M., Keck P.E., McElroy S.L., y al. Twelve-month outcome following hospitalization for affective psychosis Arch Gen Psychiatry 1998 ; 55 : 49-55 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} 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.^{15Dilsaver S., Chen Y.-H., Swann A.C., y al. Suicidality in patients with pure and depressive mania Am J Psychiatry 1994 ; 151 : 1312-1315

Haga clic aquí para ir a la sección de Referencias, 20Goodwin F.K., Jamison K.R. Manic-Depressive Illness New York: Oxford University Press (1990).

Haga clic aquí para ir a la sección de Referencias, 69Strakowski S.M., McElroy S.L., Keck P.E., y al. Suicidality in mixed and manic bipolar disorder Am J Psychiatry 1996 ; 153 : 674-676

Haga clic aquí para ir a la sección de Referencias}

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.^{22Gurling H. Linkage findings in bipolar disorder Nat Genet 1995 ; 10 : 8-9 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} 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.^{22Gurling H. Linkage findings in bipolar disorder Nat Genet 1995 ; 10 : 8-9 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} 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.^{54Post R.M. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder Am J Psychiatry 1992 ; 149 : 999-1010

Haga clic aquí para ir a la sección de Referencias} 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.^{25Hirschfeld R.M.A., Clayton P.J., Cohen I., y al. Practice Guideline for the Treatment of Patients with Bipolar Disorder Am J Psychiatry 1994 ; 151 : 1-31

Haga clic aquí para ir a la sección de Referencias}

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Esquema

EPIDEMIOLOGY AND CAUSE

Co-occurring Conditions

TREATMENT

Acute Mania (and Mixed Episodes)

Acute Depression

Maintenance

Emerging Research

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.