Bipolar I Disorder

Bipolar I Disorder is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --

Basics

Description

  • Bipolar I (BP-I) is an episodic mood disorder of at least one manic or mixed (mania and depression) episode that causes marked impairment, psychosis, and/or hospitalization; major depressive episodes are not required but usually occur.
  • Symptoms are not caused by a substance or general medical condition.

Geriatric Considerations
New onset in older patients (>50 years of age) requires a workup for organic or chemically induced pathology.

Pediatric Considerations
Diagnosis less well defined. For example, mood elevation symptoms overlap with those of ADHD.

Pregnancy Considerations
  • Pregnancy does not reduce risk of mood episodes.
  • Need to weigh risk of exposure to mood episode to that of medication
  • Avoid divalproex due to high teratogenicity risk.
  • Postpartum carries risk of severe acute episode with psychosis and/or infanticidal ideation.

Epidemiology

Onset usually between 15 and 30 years of age


Prevalence
  • 1.0–1.6% lifetime prevalence
  • Equal among men and women (manic episodes more common in men; depressive episodes more common in women)
  • Equal among races; however, clinicians tend to diagnose schizoaffective in African Americans with BP-I.

Etiology and Pathophysiology

Genetic predisposition and major life stressors can trigger initial and subsequent episodes:

  • Dysregulation of biogenic amines or neurotransmitters (particularly serotonin, norepinephrine, and dopamine)
  • MRI findings suggest abnormalities in prefrontal cortical areas, striatum, and amygdala that predate illness onset (1)[C].
Genetics
  • Monozygotic twin concordance 40–70%
  • Dizygotic twin concordance 5–25%
  • 50% have at least one parent with a mood disorder.
  • First-degree relatives are 7 times more likely to develop BP-I than the general population.

Risk Factors

Genetics, major life stressors, or substance abuse

General Prevention

No known way to prevent onset, but treatment adherence and education can help to prevent relapses.

Commonly Associated Conditions

Substance abuse (60%), ADHD, anxiety disorders, and eating disorders

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bipolar I Disorder ID - 116819 ED - Baldor,Robert A, ED - Domino,Frank J, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116819/all/Bipolar_I_Disorder PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -