Bipolar disorders: an update on critical aspects

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-01-01 DOI:10.1016/j.lanepe.2024.101135

Vincenzo Oliva , Giovanna Fico , Michele De Prisco , Xenia Gonda , Adriane R. Rosa , Eduard Vieta

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引用次数: 0

Abstract

Bipolar disorders are chronic psychiatric conditions characterized by recurrent episodes of mania and depression. Affecting over 1% of the global population, these disorders contribute significantly to disability and mortality, often due to suicide and cardiovascular disease. Diagnostic challenges arise from symptom overlap with unipolar depression, frequently leading to delays. Bipolar disorders are driven by complex genetic, neurobiological, and environmental factors and are commonly accompanied by psychiatric and medical comorbidities, further complicating diagnosis and treatment. Standard management strategies include mood stabilizers, antipsychotics, and selective use of antidepressants, complemented by psychosocial interventions like cognitive-behavioral therapy and psychoeducation, which are vital for relapse prevention. Despite recent advancements, the management of bipolar disorders remains challenging, constrained by clinical variability, an absence of specific biomarkers, and differences in approved treatments and treatment guidelines across regions. Emerging research underscores the potential of precision psychiatry and digital health tools to enhance diagnosis and treatment. Nonetheless, critical gaps persist, particularly in implementing equitable care worldwide. This review offers a comprehensive update on bipolar disorders, examining clinical presentation, early diagnosis, pathogenesis, therapeutic strategies, and future perspectives to guide clinicians and researchers in addressing these ongoing challenges in research and clinical practice.

Funding

None.

查看原文本刊更多论文

双相情感障碍：关键方面的最新进展。

双相情感障碍是一种以反复发作的躁狂和抑郁为特征的慢性精神疾病。这些疾病影响到全球1%以上的人口，严重导致残疾和死亡，通常是由于自杀和心血管疾病。诊断上的困难来自于症状与单相抑郁症的重叠，常常导致延迟。双相情感障碍是由复杂的遗传、神经生物学和环境因素驱动的，通常伴有精神和医学合并症，进一步使诊断和治疗复杂化。标准的管理策略包括情绪稳定剂、抗精神病药和选择性使用抗抑郁药，辅以认知行为疗法和心理教育等社会心理干预，这对预防复发至关重要。尽管最近取得了进展，但双相情感障碍的管理仍然具有挑战性，这受到临床变异性、缺乏特异性生物标志物以及各地区批准的治疗方法和治疗指南的差异的限制。新兴研究强调了精确精神病学和数字健康工具在提高诊断和治疗方面的潜力。然而，严重的差距仍然存在，特别是在世界范围内实施公平医疗方面。这篇综述提供了双相情感障碍的全面更新，检查临床表现，早期诊断，发病机制，治疗策略和未来的观点，以指导临床医生和研究人员在研究和临床实践中应对这些持续的挑战。资金:没有。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.