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

Cliccare qui per andare alla sezione Riferimenti</sup> 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).<sup>47 McElroy S.L., Keck P.E., Strakowski S.M. Mania, psychosis, and antipsychotics J Clin Psychiatry 1996 ;  57 : 14-26

Cliccare qui per andare alla sezione Riferimenti</sup> Untreated, bipolar disorder is associated with substantial risks of morbidity and mortality. Bipolar disorder was the sixth leading cause of disability worldwide in 1990.<sup>49 Murray C.J.L., Lopez A.D. The Global Burden of Disease: Summary Cambridge, MA: Harvard School of Public Health (1996). 

Cliccare qui per andare alla sezione Riferimenti</sup> 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.<sup>35 Keck P.E., McElroy S.L., Strakowski S.M. , e al. Twelve-month outcome of bipolar patients following hospitalization for a manic or mixed episode Am J Psychiatry 1998 ;  155 : 646-652

Cliccare qui per andare alla sezione Riferimenti, 66 Strakowski S.M., Keck P.E., McElroy S.L. , e al. Twelve-month outcome following hospitalization for affective psychosis Arch Gen Psychiatry 1998 ;  55 : 49-55  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> 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.<sup>15 Dilsaver S., Chen Y.-H., Swann A.C. , e al. Suicidality in patients with pure and depressive mania Am J Psychiatry 1994 ;  151 : 1312-1315

Cliccare qui per andare alla sezione Riferimenti, 20 Goodwin F.K., Jamison K.R. Manic-Depressive Illness New York: Oxford University Press (1990). 

Cliccare qui per andare alla sezione Riferimenti, 69 Strakowski S.M., McElroy S.L., Keck P.E. , e al. Suicidality in mixed and manic bipolar disorder Am J Psychiatry 1996 ;  153 : 674-676

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

Cliccare qui per andare alla sezione Riferimenti</sup> 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.<sup>22 Gurling H. Linkage findings in bipolar disorder Nat Genet 1995 ;  10 : 8-9  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> 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.<sup>54 Post R.M. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder Am J Psychiatry 1992 ;  149 : 999-1010

Cliccare qui per andare alla sezione Riferimenti</sup> 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.<sup>25 Hirschfeld R.M.A., Clayton P.J., Cohen I. , e al. Practice Guideline for the Treatment of Patients with Bipolar Disorder Am J Psychiatry 1994 ;  151 : 1-31

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