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Editorial| Volume 48, ISSUE 6, P430-432, September 15, 2000

Treatment advances in bipolar disorder—making up for lost time

DOI:https://doi.org/10.1016/S0006-3223(00)00990-2
Treatment advances in bipolar disorder—making up for lost time
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      Much ground has been gained in recent years in improving treatments for people with bipolar disorder. These exciting developments are long overdue. As recently as 1993, only one medication, lithium, was approved for the treatment of this severe, recurrent illness. Psychotherapeutic strategies had been either neglected or abandoned. Several factors seem to have contributed to this protracted period of therapeutic quiescence. First, lithium was presumed to be an effective medication for most phases of bipolar disorder for most patients. Clinical lore had long held that most patients recovered fully from affective episodes and went on to experience long periods of euthymia and good functioning. Psychotherapeutic approaches were either thought to be irrelevant in this biological illness or appropriated willy-nilly from applications in other illnesses. Subsequent studies have shown that these beliefs were seriously wrong. Only a minority of patients with bipolar disorder experience the salutary effects of lithium monotherapy (
      • Maj M.
      The impact of lithium prophylaxis on the course of bipolar disorder A review of the research evidence.
      Bipolar Disord. 2000; 2: 93-101
      ). Many patients have great difficulty returning to their previous level of functioning after experiencing an affective episode, and recurrent episodes can lead to permanent disability (
      • Keck Jr, P.E.
      • McElroy S.L.
      • Strakowski S.M.
      • West S.A.
      • Sax K.W.
      • Hawkins J.M.
      • et al.
      Twelve-month outcome of bipolar patients following hospitalization for a manic or mixed episode.
      Am J Psychiatry. 1998; 155: 646-652
      ). Bipolar disorder was the sixth leading cause of disability worldwide in 1990 and, without further treatment advances, was projected to remain so into this century (
      • Murray C.J.L.
      • Lopez A.D.
      The Global Burden of Disease Summary. Harvard School of Public Health, Cambridge, MA1996
      ). The cost of this illness in human suffering is profound and immeasurable (
      • Coryell W.
      • Scheftner W.
      • Keller M.
      • Endicott J.
      • Maser J.
      • Klerman G.L.
      The enduring psychosocial consequences of mania and depression.
      Am J Psychiatry. 1993; 150: 720-727
      ). The articles in this issue of Biological Psychiatry document recent research efforts to gain ground in the struggle to improve the lives of people with bipolar disorder.
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      Article info

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      DOI: https://doi.org/10.1016/S0006-3223(00)00990-2

      Copyright

      © 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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