Bipolar Disorders: Mixed States, Rapid Cycling, and Atypical Forms

Since the description of main depressive insanity by Emil Kraepelin, bipolar disorder has been on the forefront of psychiatric research. But even after the recent advancements in knowledge about this illness, in many ways it remains a poorly understood disease. Despite all we know, this illness is often unrecognized or misdiagnosed and ineffectively or inappropriately treated.

One of the main reasons for this suboptimal treatment is the heterogeneity of the clinical presentation associated with bipolar disorder. Therefore, I welcome the publication of Bipolar Disorders . In this volume Dr. Marneros and Dr. Goodwin have compiled succinct and readable summaries about a wide range of topics pertaining to atypical affective disorders. The list of contributors from both sides of the Atlantic is impressive. Many are considered top experts in their area. In addition, the book also gives a unique European perspective on the development of ideas about bipolar disorder.

The book is divided into 17 chapters. The first chapter reviews the root and evolution of the concept of bipolar disorder since Hippocrates and traces it to modern times. Chapters 2 through 4 focus on the mixed and rapid-cycling forms of manic illness. Chapters 5 through 7 present very good summaries of current knowledge about the atypical forms of depression. Two excellent chapters discuss the unique problems of diagnosis and treatment of bipolar disorders in special populations, such as children and the elderly. A synopsis of genetic research in bipolar illness is also included.

The timely question about the use of atypical agents as monotherapy in the treatment of bipolar disorders is addressed at length in the two chapters that focus on treatment. Finally, the various issues in conducting clinical research on bipolar disorders are addressed in the last chapter.

On the whole, the book is well integrated and easy to read. The editors have made an impressive effort to ensure that the material flows naturally and without duplication. Tables and figures are used appropriately and complement the text. The references are up to date, and the book is complete with good references.

This timely and concise review about bipolar disorder is likely to attract a wide readership, though the primary audiences are psychiatrists and other clinicians working in the area of mood disorders, especially those involved in research. A relative area of weakness is the lack of a comprehensive review of psychosocial interventions targeting bipolar disorder. Similarly, issues of relapse prevention, access to services, and cultural aspects were not covered in as much detail. However, the book accomplishes its core task of presenting scientific and biologic knowledge about various forms of bipolar disorder.