Bipolar disorder.
Balwinder Singh, Holly A Swartz, Alfredo B Cuellar-Barboza, Ayal Schaffer, Tadafumi Kato, Annemieke Dols, Sarah H Sperry, Andrea B Vassilev, Katherine E Burdick, Mark A Frye
Lancet (London, England) July 22, 2025 DOI: 10.1016/S0140-6736(25)01140-7 via PubMed
Summary
AI-generated from the abstractBipolar disorder, marked by hypomania or mania and predominantly depression, affects about 40 million people worldwide and carries substantial psychosocial, medical, and financial burdens, along with increased suicide risk. Diagnosis is often delayed due to symptom overlap with ADHD, major depression, psychotic disorders, and personality disorders. Recent research points to multigene risk and possible infectious and mitochondrial causes. Treatment combines pharmacotherapy, psychotherapy, and lifestyle changes, tailored to individual goals. Future priorities include expanding self-management psychosocial interventions, addressing treatment-resistant depression, deepening understanding of pathophysiology, and exploring novel options like ketamine, esketamine, and neuromodulation.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Keywords | Bipolar disorder Mental health treatment Disease etiology Diagnostic challenges |
| Citations | 66 |
| Key finding | Bipolar disorder diagnosis is often delayed due to symptom overlap with other psychiatric conditions, and recent research identifies multigene risk and possible infectious and mitochondrial causes. |
Abstract
The hallmark of bipolar disorder is hypomania or mania, and the predominant phase of illness is depression. Affecting approximately 40 million individuals worldwide, bipolar disorder is associated with a substantial psychosocial, medical, and financial burden and increased mortality from suicide and other causes. Diagnosis can be challenging due to symptom overlap with attention-deficit hyperactivity disorder, major depressive disorder, psychotic spectrum disorders, and personality disorders, which often leads to a delay in diagnosis. Recent advancements in understanding disease risk and pathophysiology have identified multigene risk and possible infectious and mitochondrial causes. Treatment approaches include pharmacotherapy, psychotherapy, and lifestyle modifications, which should always be patient-centred and aligned with individual goals and priorities. Future directions for bipolar disorder care include increasing the availability of psychosocial interventions aimed at self-management, addressing treatment-resistant bipolar depression, deepening the understanding of pathophysiology, and exploring novel interventions, such as ketamine, esketamine, other rapid-acting antidepressants, and various neuromodulation approaches.