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Bipolar II disorder : a review
journal contribution
posted on 2005-02-01, 00:00 authored by Michael BerkMichael Berk, Seetal DoddSeetal DoddObjectives: To review the current knowledge of bipolar II disorder.
Methods: Literature was reviewed after conducting a Medline search and a hand search of relevant literature.
Results: Bipolar II disorder is a common disorder, with a prevalence of approximately 3–5%. Distinct clinical features of bipolar II disorder have been described. The key to diagnosis is the recognition of past hypomania, while depression is the typical presenting feature of the illness. This is responsible for a significant rate of missed diagnosis, and consequent management according to unipolar guidelines. It is unclear if bipolar II disorder is over-represented amongst resistant depression populations and if abrupt offset of antidepressant action is a phenomenon over represented in bipolar II disorder, reflecting induction of predominantly depressive cycling. A few mood-stabilizer studies available provide provisional suggestion of utility. A supportive role for psychosocial therapies is suggested, however, there is a sparsity of published studies specific to bipolar II disorder cohorts. A small number of short-term antidepressant trials have suggested efficacy, however, compelling long-term maintenance data is absent.
Conclusions: An emerging literature on the specific clinical signature and management of the disorder exists, however, this is disproportionately small relative to the epidemiology and clinical significance of the disorder.
Methods: Literature was reviewed after conducting a Medline search and a hand search of relevant literature.
Results: Bipolar II disorder is a common disorder, with a prevalence of approximately 3–5%. Distinct clinical features of bipolar II disorder have been described. The key to diagnosis is the recognition of past hypomania, while depression is the typical presenting feature of the illness. This is responsible for a significant rate of missed diagnosis, and consequent management according to unipolar guidelines. It is unclear if bipolar II disorder is over-represented amongst resistant depression populations and if abrupt offset of antidepressant action is a phenomenon over represented in bipolar II disorder, reflecting induction of predominantly depressive cycling. A few mood-stabilizer studies available provide provisional suggestion of utility. A supportive role for psychosocial therapies is suggested, however, there is a sparsity of published studies specific to bipolar II disorder cohorts. A small number of short-term antidepressant trials have suggested efficacy, however, compelling long-term maintenance data is absent.
Conclusions: An emerging literature on the specific clinical signature and management of the disorder exists, however, this is disproportionately small relative to the epidemiology and clinical significance of the disorder.
History
Journal
Bipolar disordersVolume
7Issue
1Pagination
11 - 21Publisher
Wiley - BlackwellLocation
Malden, MassPublisher DOI
ISSN
1398-5647eISSN
1399-5618Language
engNotes
Article first published online 14 JAN 2005Publication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2005, Blackwell MunksgaardUsage metrics
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Categories
Keywords
bipolar disorderbipolar IIdepressionhypomaniaunipolarScience & TechnologyLife Sciences & BiomedicineClinical NeurologyNeurosciencesPsychiatryNeurosciences & NeurologyBORDERLINE PERSONALITY-DISORDERPLACEBO-CONTROLLED TRIALANTIDEPRESSANT-ASSOCIATED HYPOMANIALITHIUM MAINTENANCE TREATMENTMAJOR AFFECTIVE-DISORDERDEPRESSION RATING-SCALEIV ATYPICAL FEATURESDOUBLE-BLINDDIVALPROEX SODIUMGRADUAL DISCONTINUATION