Recent findings in bipolar affective disorder

Abstract

Goodwin (2000) famously argued that bipolar disorder was the Cinderella of psychiatry. It certainly should not be: there is no doubt of the anguish caused by the condition, in particular the excess of natural mortality and the great excess of death by suicide (Ösby et al. 2001). In this issue, Mitchell et al. (2004) report that 26% of their cases of bipolar disorder had attempted suicide at some point. This reflects the sheer persistence of personal suffering: Judd and colleagues (2002, 2003) demonstrated in a long and detailed follow-up that patients with bipolar disorder were symptomatic at least half the time. The Australian National Survey of Psychotic Disorders found levels of disability in affective psychosis equal to those of schizophrenia (Jablensky et al. 2000), and bipolar cases are more likely to score highly on measures of disability than unipolar cases (Mitchell et al. 2004). People with bipolar disorder are more likely to be single, widowed or divorced than both the general populace and those with unipolar depression (Mitchell et al. 2004).

Subtyping schizophrenia: implications for genetic research

“…This might be part of the reason for the limited capacity of the diagnosis to predict accurately which biological or behavioural attributes will be shared by the majority of individuals allocated to the diagnostic category, or to draw 'zones of rarity' 51 that clearly demarcate schizophrenia from other disorders, such as bipolar affective disorder. 52,53 Such flaws raise doubts about the capacity of the broad clinical definition of schizophrenia to carve out biologically homogeneous clinical populations for genetic analysis.…”

A prospective study of dysfunctional thinking and the regulation of negative intrusive memories in bipolar 1 disorder: implications for affect regulation theory

“…Overall, these studies indicate that people with BP disorder display dysfunctional thinking patterns when compared to healthy controls, but these cognitive styles show striking similarities to those of UP depressed patients (Scott & Pope, 2003 ;Lam et al 2004;Jones et al 2005). There is some evidence that dysfunctional cognitive styles can be identified in remission, suggesting that they might present an enduring vulnerability to the disorder; however, because of the paucity of more powerful prospective studies that include groups of BP participants at different stages of the disorder, as well as UP and healthy controls, it is difficult to establish the role that cognitive factors play in the maintenance of BP disorder or in predicting transition from one phase of the disorder to another (Bebbington, 2004;Alloy et al 2005).…”

Studies of the affective and developmental domains of psychopathology in psychosis

“…A significant association between trauma with hallucinations as outcome and subclinical comorbidity was found, entirely in line with the findings of a previous study (Hammersley et al, 2003). No association was found between childhood trauma and comorbidity between mania and psychosis at a subclinical level, whereas trauma has been found to be a risk factor for psychosis (Read et al, 2005) as well as bipolar disorder (Hammersley et al, 2003) (Bebbington, 2004;Garno et al, 2005;Levitan et al, 1998).…”