Bipolar affective disorder
Bipolar affective disorder is a mental disorder that mainly affects mood, emotions, thinking and behaviour.
Patients with bipolar disorder experience periods of euphoria or agitation, alternating with depression.
Of all the clinical and psychosocial issues associated with bipolar affective disorder, the biggest concern is SUICIDAL RISK!
Depressive episode is characterized by: depressed mood or loss of interest and pleasure, duration of the episode is at least 2 weeks. The list of depressive symptoms includes: depressed mood, loss of interest and pleasure in all activities, significant weight loss or gain, insomnia or hypersomnia, agitation or psychomotor inhibition, feelings of sadness, worthlessness and suicidal ideation (recurrent thoughts of death).
The manic episode is characterized by: euphoric, expansive or irritable mood, the duration of the episode is at least 7 days. Manic symptoms include: increased self-esteem, unrealistic self-confidence, euphoria, increased sexual drive, decreased physiological need for sleep and psychomotor agitation.
Epidemiology
Around 1% of the world’s population suffers from bipolar disorder. The prevalence of the disease is similar in both sexes, as it is in different cultures and/or ethnic groups. The ages of onset of the condition are late adolescence and young adulthood (15-44 years).
Risk factors
The aetiopathogenesis of bipolar affective disorder includes genetic, physiological and environmental factors.
The risk factors for bipolar affective disorder are:
- positive family history of bipolar affective disorder,
- drug or alcohol abuse,
- living through a traumatic life experience (e.g. physical, sexual or emotional abuse),
- negative (divorce, death of a loved one) or positive (marriage) stressful life events,
- the presence of another somatic disease,
- night shift work.
Diagnosis
is based on the description of symptoms experienced by the subject, but also on abnormal behaviour described by family, friends or colleagues, followed by the observation of other signs during clinical assessment by psychiatrists, specialist nurses or specialist psychologists. Assessment of cases is usually carried out on an outpatient basis. Hospitalization is necessary in cases of risk to the individual or the entourage.
The differential diagnosis encompasses several psychiatric conditions that manifest themselves with symptoms similar to those of bipolar disorder – schizophrenia, ADHD, personality disorders, including borderline personality disorder. Anyone with a history of mania/hypomania and depression is forever diagnosed with bipolar disorder, regardless of the subsequent course and length of remission periods; according to official criteria, no case is considered cured, only in remission.
Abuse of various drugs and medications (cocaine, amphetamine, steroids, propranolol) can also complicate the course of the disease.
Treatment
includes a number of psychotherapy medications and techniques (cognitive behavioural therapy, family therapy, group therapy, crisis intervention and psychoeducation). Although bipolar disorder is chronic, persisting throughout life, its symptoms can be managed. It is necessary to combine psychotherapy with pharmacological treatment under the close supervision of a specialist psychiatrist, as studies have shown that this combination leads to a significant decrease in relapses. Making certain lifestyle changes, as well as support from close people, contributes significantly to symptom management.
Most of the time treatment is a lifelong process, even if the symptoms have disappeared!
Prognosis
The prognosis is good following the right therapy. Although it can be a medical condition that can lead to serious problems affecting different aspects of life, under treatment, many patients with bipolar disorder lead normal and full lives (medication treatment is required).
Remission and relapse: In the most severe cases, which required hospitalization for the first manic/mixed episode – 50% were in remission within 6 weeks and 98% within 2 years.
The suicide mortality rate in bipolar disorder is between 18 and 25%.
Bipolar affective disorder is a manageable illness
At Med Anima Clinic, this condition is treated using genetic testing.
Future directions:
- Identifying genes that confer vulnerability
- Optimising psychosocial interventions
- New medicines with increased efficacy and tolerability
- Understanding evolution and superior quality management
- Early identification, diagnosis and treatment
- Resolving diagnostic controversies
- Resolving controversy over the relevance of ancillary symptoms
- Resolving controversies on the administration of antidepressants
- Destigmatising the patient with bipolar affective disorder
Find out more
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