The ECNP consensus statement on bipolar depressionJuly 09, 2008Bipolar disorder is one of the most complex and challenging mental disorder in the spectrum. Bipolar disorder is typically associated with considerable acute and longterm treatment needs and may be associated in the course of illness with times of tremendous social burden for both the individual and family. It is typically referred to as an episodic, yet lifelong and clinically severe mood disorder. The disorder is called bipolar, because depressive and manic mood episodes alternate in the course of illness. Because the manic part may be sometimes less impairing and disabling, clinicians differentiate the less severe expression with euphoria and/or extreme irritability - called hypomania - as Bipolar II as opposed to the more dramatic and severe mania (called Bipolar I disorder). The long-term course of bipolar disorder is usually dominated by depressive rather than (hypo)manic symptoms, and disease onset tends to be earlier than in patients showing only major depression. A major challenge in the treatment of patients with mood disorders is the distinction between bipolar and unipolar depression from early on, since these conditions may require different types of treatment. Unfortunately, all too often patients with bipolar depression remain untreated or improperly treated. Over the last 10-15 years, there has been an increasing awareness and knowledge about bipolar disorder reflecting the explosion on all fronts in the biomedical literature. Everybody struggles to keep up to. To take account of the accumulating evidence and experience, the European College of Neuropsychopharmacology (ECNP) recently published a consensus statement that provides an expert summary of state-of-the-art knowledge concerning all aspects of bipolar depression, and broader issues of bipolarity. The highlights of this statement will be presented by the renowned British researcher Guy M. Goodwin from the University Department of Psychiatry, Warneford Hospital, Oxford. The apparent differences between unipolar and bipolar depression arise in diagnosis and epidemiology, bipolar depression in children as well as adults, the use of rating scales, and finally treatment studies to optimize pharmacotherapy and clinical outcome.
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