Bipolar affective disorder—left out in the cold

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7329.61 (Published 12 January 2002) Cite this as: BMJ 2002;324:61

Too late for the national service framework but local initiatives may be possible

  1. Richard Morriss, professor of psychiatry,
  2. Max Marshall, reader in psychiatry,
  3. Amanda Harris, research psychologist
  1. Department of Psychiatry, University of Liverpool, Royal Liverpool University Hospital, Liverpool L69 3GA
  2. Department of Psychiatry, University of Manchester, Royal Preston Hospital, Preston PR2 9HT
  3. Manic Depression Fellowship, Castle Works, London SE1 6ES

    The national strategic framework for mental health states that “one person in 250 will have a psychotic illness such as schizophrenia or bipolar affective disorder.” It goes on to cite bipolar affective disorder as one of the 10 leading causes of disability worldwide in adults aged 15-44.1 How surprising then that the service needs of people with bipolar affective disorder receive no specific consideration in this major policy document.

    There are four reasons why the national service framework should have given special consideration to the needs of people with bipolar affective disorder. Firstly, most patients with bipolar affective disorder have the potential, with optimal treatment, to return to normal function and contribute to the economy. With suboptimal treatment, however, many will have a poor long term outcome and needlessly become a burden to families and society.2 Yet there is evidence that treatment is generally suboptimal. For example, a survey (n=1004) of members of the Manic Depression Fellowship, a British organisation for people with bipolar affective disorder, found that only 19% were in full time work, although 40% were graduates and 69% wanted to work.3 Longitudinal observational …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription