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Bipolar disorder—services need to catch up with rapidly developing evidence base

BMJ 2006; 332 doi: (Published 05 January 2006) Cite this as: BMJ 2006;332:32
  1. John Geddes, professor of epidemiological psychiatry (
  1. 1 University of Oxford, Warneford Hospital, Oxford OX10 0RU

    The article above powerfully describes the misery and anguish that bipolar disorder causes.1 Bipolar disorder is characterised by disabling swings of mood between mania (and mixed mania and depression) and depression. In the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), it is subdivided depending on the severity of the manic symptoms: bipolar I disorder is diagnosed when episodes of mania or mixed episodes occur with or without episodes of depressive illness, and bipolar II disorder is diagnosed when depression occurs with less severe episodes of elevated mood (hypomania) that do not lead to dysfunction or disability.1 The lifetime prevalence of bipolar I disorder is around 0.5%; including bipolar II and less severe bipolar spectrum disorder increases this to around 5%.2 The aetiology of bipolar disorder remain uncertain. It is strongly familial, although …

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