Bipolar disorder: etiology, diagnosis, and management

PURPOSE: To review the epidemiology and disease characteristics of the bipolar disorder (BD) spectrum, render an accurate and timely diagnosis, and review treatment options through provider and patient collaboration. DATA SOURCES: Comprehensive review of current scientific literature derived from electronic databases and professional medical references. CONCLUSIONS: BD is a multifactorial disease that can interfere with cognition and behavior, causing a severe impact on patients and families. The variable course and often delayed diagnosis of this disorder can cause frustration for the patient and the healthcare provider. Because most undiagnosed patients with BD seek treatment within the primary care setting, it is imperative that clinicians become expert in the recognition of and intervention for this condition. IMPLICATIONS FOR PRACTICE: The primary care provider is in a key position to render early diagnosis and treatment of BD. This disease should always be considered as part of the differential diagnosis for depression or anxiety. Nurse practitioners can be effective providers by using good nursing practices of communication, education, and advocacy for the patient and family. Knowledge of current diagnostic criteria and management is imperative for successful treatment of patients with BD.