Mood disorders

Macroeconomics

Hypomania

Depression (economics)

Psychiatry

Bipolar disorder

Economics

Anxiety

Environmental health

Mania

Psychology

Population

Internal medicine

Psychosocial

Mood

Medicine

Clinical psychology

Disease

Nature Reviews Disease Primers

Bipolar disorders are chronic and recurrent disorders that affect &gt;1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease. Psychiatric and nonpsychiatric medical comorbidities are common in patients and might also contribute to increased mortality. Bipolar disorders are some of the most heritable psychiatric disorders, although a model with gene–environment interactions is believed to best explain the aetiology. Early and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand the significance of their symptoms, especially with hypomanic or manic symptoms. As specific biomarkers for bipolar disorders are not yet available, careful clinical assessment remains the cornerstone of diagnosis. The detection of hypomanic symptoms and longtudinal clinical assessment are crucial to differentiate a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary. Bipolar disorders are characterized by acute episodes of mania or hypomania and depression. Psychosis can occur in some patients, and cognitive symptoms, including deficits in executive function and memory, are frequent. In this Primer, Vieta et al. discuss the epidemiology, mechanisms, diagnosis and management of bipolar disorders.

Bipolar disorders