Get access

Public health significance of bipolar disorder: implications for early intervention and prevention

Authors

  • Philippe Conus,

    Corresponding author
    1. Service de Psychiatrie Générale, Département Universitaire de Psychiatrie CHUV, Lausanne University, Clinique de Cery, Prilly, Switzerland
    • Corresponding author:

      Professor Philippe Conus, M.D.

      Service de Psychiatrie Générale

      Département Universitaire de Psychiatrie CHUV

      Université de Lausanne

      Clinique de Cery

      Prilly 1008

      Switzerland

      Fax: +41-21-644-64-69

      E-mail: philippe.conus@chuv.ch

    Search for more papers by this author
  • Craig Macneil,

    1. Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), Parkville, Vic., Australia
    Search for more papers by this author
  • Patrick D McGorry

    1. Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), Parkville, Vic., Australia
    Search for more papers by this author

Abstract

Objectives

Early intervention and preventive strategies have become major targets of research and service development in psychiatry over the last few years. Compared to schizophrenia, bipolar disorder (BD) has received limited attention in this regard. In this paper, we review the available literature in order to explore the public health significance of BD and the extent to which this may justify the development of early intervention strategies for this disorder.

Methods

The main computerized psychiatric literature databases were accessed. This included Medline and PsychInfo, using the following keywords: bipolar, early intervention, staging model, burden, caregiver, public health, and manic depression.

Results

BD is often recurrent and has an impact that goes well beyond symptomatic pathology. The burden it incurs is linked not only to its cardinal clinical features, but also to cognitive dysfunction, poor functional outcome, poor physical health, high rate of comorbidities, and suicide. At a societal level, BD induces enormous direct and indirect costs and has a major impact on caregivers. The available literature reveals a usually long delay between illness onset and the start of treatment, and the absence of specific guidelines for the treatment of the early phase of BD.

Conclusions

Considering the major impact of BD on patients and society, there is an urgent need for the development of early intervention strategies aimed at earlier detection and more specific treatment of the early phase of the disorder.

Get access to the full text of this article

Ancillary