Bipolar disorder: a heterogeneous illness that requires a broader perspective of approach
DOI:
https://doi.org/10.25118/2763-9037.2012.v2.899Keywords:
bipolar disorder, epidemiology, clinic, primary prevention, secondary preventionAbstract
The authors review the literature on the epidemiological and clinical characteristics, course and evolution, as well as comorbidities and morbidity and mortality of bipolar disorder. Due to the heterogeneity of the disease, a broader perspective of approach to the disease is proposed, encompassing primary prevention and rehabilitation of more compromised cases, including secondary prevention as the primary objective in properly diagnosed cases. It is proposed to return to medical reasoning and the sum of clinical evidence to establish the multiaxial diagnosis and the necessary intervention strategies.
Downloads
Metrics
References
Goodwin FK, Jamison KR. Manic-Depressive Illness. 2nd ed. New York: Oxford University Press; 2007.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
Soares OT, Moreno DH, de Moura EC, Angst J, Moreno RA. Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ). Rev Bras Psiquiatr. 2010;32:416-23. DOI: https://doi.org/10.1590/S1516-44462010000400015
Angst J, Meyer DT, Adolfsson R, Skeppar P, Carta M, Benazzi F, Lu RB, Wu YH, Yang HC, Yuan CM, Morselli P, Brieger P, Katzmann J, Leão IAT, del Porto JA, Moreno DH, Moreno RA, Soares OT, Vieta E, Gamma A. Hypomania: a transcultural perspective. World Psychiatry 2010;9:41-9. DOI: https://doi.org/10.1002/j.2051-5545.2010.tb00268.x
Ratzke R, Moreno DH, Gorenstein C, Moreno RA. Validity and reliability of the Structured Clinical Interview for Mood Spectrum – Brazilian Version (SCIMOODS--VB). Rev Bras Psiquiatr. 2011;33:64-7. DOI: https://doi.org/10.1590/S1516-44462011000100013
Angst J, Gamma A, Benazzi F, Adjacic V, Eich D, Rossler W. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord. 2003;73:133-46. DOI: https://doi.org/10.1016/S0165-0327(02)00322-1
Merikangas KR, Akiskal HS, Angst J et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2007;64:543-52.
Moreno DH, Dias RS. Epidemiologia. In: Moreno RA, Moreno DH, editors. Da Psicose Maníaco-Depressiva ao Espectro Bipolar. 3 ed. São Paulo: Segmento Farma; 2008:126-146.
Moreno DH, Andrade LH. Latent class analysis of manic and depressive symptoms in a population-based sample in São Paulo, Brazil. J Affect Disord. 2010 ;123:208-15. DOI: https://doi.org/10.1016/j.jad.2009.09.023
Merikangas KR, Jin R, He J, Kessler RC, Lee S, Sampson NA, Viana MC, Andrade LH, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry 2011;68:241-251. DOI: https://doi.org/10.1001/archgenpsychiatry.2011.12
Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. [published correction appears in Arch Gen Psychiatry. 2007;64(9):1039] Arch Gen Psychiatry. 2007;64:543–552. DOI: https://doi.org/10.1001/archpsyc.64.5.543
Perlis RH, Miyahara S, Marangell LB, et al. Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Biol Psychiatry. 2004;55:875–881. DOI: https://doi.org/10.1016/j.biopsych.2004.01.022
Neighbors HW, Trierweiler SJ, Ford BC, et al. Racial differences in DSM diagnosis using a semi-structured instrument: the importance of clinical judgment in the diagnosis of African Americans. J Health Soc Behav. 2003;44:237–256. DOI: https://doi.org/10.2307/1519777
Suppes T, Mintz J, McElroy SL, et al. Mixed hypomania in 908 patients with bipolar disorder evaluated prospectively in the Stanley Foundation Bipolar Treatment Network: a sex-specific phenomenon. Arch Gen Psychiatry. 2005;62:1089–1096. DOI: https://doi.org/10.1001/archpsyc.62.10.1089
Newberg AR, Catapano LA, Zarate CA, Manji HK. Neurobiology of bipolar disorders. Expert Rev Neurotherapeutics 2008, 8:93-110. DOI: https://doi.org/10.1586/14737175.8.1.93
Campos RN, Campos JAO, Sanches M. Evolução Histórica dos Conceitos de Transtorno de Humor e Transtornos de Personalidade: Problemas no Diagnóstico Diferencial. Rev Psiq Clín. 2010;37:162-6. DOI: https://doi.org/10.1590/S0101-60832010000400004
Judd LL, Schettler PJ, Akiskal HS, Maser J, Coryell W, Solomon D, et al. Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol. 2003;6:127-37. DOI: https://doi.org/10.1017/S1461145703003341
Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry.2003a;60:261-9. DOI: https://doi.org/10.1001/archpsyc.60.3.261
Moreno DH, Campos RN. Curso e evolução. In: Moreno RA, Moreno DH., editors. Da Psicose Maníaco--Depressiva ao Espectro Bipolar. 2ª ed. São Paulo: Segmento Farma; 2008:177-190.
McElroy SL, Altshuler LL, Suppes T, et al. Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am JPsychiatry. 2001;158:420–426. DOI: https://doi.org/10.1176/appi.ajp.158.3.420
McIntyre RS, Konarski JZ, Yatham LN. Comorbidity in bipolar disorder: a framework for rational treatment selection. Hum Psychopharmacol. 2004;196:369–386. DOI: https://doi.org/10.1002/hup.612
World Health Organization. The World Health Report 2001: mental health: new understanding, new hope. http://www.who.int/whr/2001/en. Published 2001. Acessado em 03 de Julho de 2011.
Dell’Osso B, Buoli M, Bortolussi S, Vecchi V, Camuri G, Altamura AC. Patterns of Axis I comorbidity in relation to age in patients with bipolar disorder: a cross-sectional analysis. J Affect Disord. 2011;130:318-22. DOI: https://doi.org/10.1016/j.jad.2010.10.008
Petresco S, Gutt EK, Krelling R, Lotufo-Neto F, Rohde LAP, Moreno RA. The prevalence of psychopathology in offspring of bipolar women from a Brazilian tertiary Center. Rev Bras Psiquiatr. 2009;31:240-6. DOI: https://doi.org/10.1590/S1516-44462009000300009
Lewinsohn PM, Seeley JR, Buckley ME, Klein DN. Bipolar disorder in adolescence and young adulthood. Child Adolesc Psychiatr Clin N Am. 2002;11:461-175,vii. DOI: https://doi.org/10.1016/S1056-4993(02)00005-6
Duffy A, Alda M, Crawford L, Millin R, Grof P. The early manifestation of bipolar disorder: a longitudinal prospective study of the offpring of bipolar parents. Bipolar Disord. 2007;9:828-838. DOI: https://doi.org/10.1111/j.1399-5618.2007.00421.x
Henin A, Biederman J, Mice E, Sachs GS, Hirshfeld-Becker DR, Siegel RS, McMurrich S, Grandin L, Nierenberg AA. Psychophathology in the offspring of parents with bipolar disorder: a controlled study. Biol Psychiatr. 2005;58:554-561 DOI: https://doi.org/10.1016/j.biopsych.2005.06.010
Fajutrao L, Lacklear J, Priaulx J etal. A systematic review of the evidence of the burden of bipolar disorder in Europe. Clin Pract Epidemiol Ment Health 2009; 5:3. DOI: https://doi.org/10.1186/1745-0179-5-3
WHO. The global burden of disease: 2004 update. WHO. Geneve, Switzerland 2008. http://www.who.int/whr/2001/en. Published 2001. Acessado em 03 de Julho de 2011.
Laursen TM, Munk-Olsen T, Gasse C. Chronic somatic comorbidity and excess mortality due to natural causes in persons with schizophrenia or bipolar affective disorder. PLoS One. 2011;6:e24597. DOI: https://doi.org/10.1371/journal.pone.0024597
Laursen TM. Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophr Res. 2011 Sep;131:101-4. DOI: https://doi.org/10.1016/j.schres.2011.06.008
Valtonen H, Suominen K, Mantere O, et al. Suicidal ideation and attempts in bipolar I and II disorders. J Clin Psychiatry. 2005;66:1456–1462. DOI: https://doi.org/10.4088/JCP.v66n1116
Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta--analysis of the evidence. Bipolar Disord. 2010;12:1-9. DOI: https://doi.org/10.1111/j.1399-5618.2009.00786.x
de Abreu LN, Nery FG, Harkavy-Friedman JM, de Almeida KM, Gomes BC, Oquendo MA, Lafer B. Suicide attemps are associated with worse quality of life in patients with bipolar disorder type I. Compr Psychiatr, 2012;53:125-9. DOI: https://doi.org/10.1016/j.comppsych.2011.03.003
Moreno DH, Andrade LH. The lifetime prevalence, health services utilization and risk of suicide of bipolar spectrum subjects, including subthreshold categories in the São Paulo ECA study. J Affect Disord. 2005;87:231-41. DOI: https://doi.org/10.1016/j.jad.2005.04.010
Begley CE, Annegers JF, Swann AC, et al. The lifetime cost of bipolar disorder in the US: an estimate for new cases in 1998. Pharmacoeconomics. 2001;19:483–495. DOI: https://doi.org/10.2165/00019053-200119050-00004
Moreno RA, Moreno DH, Soares MBM, Ratzke R. Anticonvulsivantes e antipsicóticos no tratamento do transtorno bipolar. Rev Bras Psiquiatr. 2004;26:37-43. DOI: https://doi.org/10.1590/S1516-44462004000700009
Goldberg JF. Optimizing treatment outcomes in bipolar disorder under ordinary conditions. J Clin Psychiatry. 2008; 69:11-9. DOI: https://doi.org/10.4088/JCP.0108e01
Beyer JL. An evidence-based medicine strategy for achieving remission in bipolar disorder. J Clin Psychiatry. 2008; 69:31-7.
Fountoulakis KN, Vieta E, Siamouli M, Valenti M, Magiria S, Oral T, Giannakopoulos P, Kaprinis GS. Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder. Ann Gen Psychiatry 2007;6:27. DOI: https://doi.org/10.1186/1744-859X-6-27
Campos RN, Costa LF, Bio DS, Soeiro-de-Souza MG, Garcia CRL, Demetrio FN, Moreno DH, Moreno RA. LICAVAL: combination therapy in acute and maintenance treatment of bipolar disorder. Trials 2010; 11:72. DOI: https://doi.org/10.1186/1745-6215-11-72
Stephens JC. Single-nucleotide polymorfism, haplotypes, and their relevance to pharmacogenetics. Mol Diagn 1999;4:309-7. DOI: https://doi.org/10.1016/S1084-8592(99)80007-1
www.fapesp.br/pesquisa/2001-12909-6
§Corresponding author
Ricardo Alberto Moreno
Downloads
Published
How to Cite
Conference Proceedings Volume
Section
License
Copyright (c) 2012 Ricardo Alberto Moreno, Rodolfo Nunes Campos, Doris Hupfeld Moreno
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria allows the author (s) to keep their copyrights unrestricted. Allows the author (s) to retain their publication rights without restriction. Authors should ensure that the article is an original work without fabrication, fraud or plagiarism; does not infringe any copyright or right of ownership of any third party. Authors should also ensure that each one complies with the authorship requirements as recommended by the ICMJE and understand that if the article or part of it is flawed or fraudulent, each author shares responsibility.
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) - Debates em Psiquiatria is governed by the licencse CC-By-NC
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
