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Views & Reviews From the Frontline

Bad medicine: bipolar II disorder

BMJ 2011; 342 doi: (Published 04 May 2011) Cite this as: BMJ 2011;342:d2767
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

News stories report a rise in bipolar illness.

In fact, this reflects an increase in bipolar II disorder, which, unlike bipolar I, has no mania or psychotic features. For the diagnosis of bipolar II there need only be one episode of depression and one episode of hypomania (periods of increased productivity, a reduced need for sleep, risk taking, and inflated self esteem), this hypomania lasting more than four days. Recent UK research claims that up to 21% of primary care patients with depression have in fact unrecognised bipolar disorder (Smith et al, Unrecognised bipolar disorder in …

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