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Controversies in Bipolar Disorders

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While pharmacotherapy and other biological treatment options form the foundation for successful treatment of bipolar disorder for more than seven decades, several therapeutic interventions are still controversial and sometimes its applications may differ across continents, countries or clinical settings quite significantly. This collection of articles aims to present four areas of controversy and uncertainty in bipolar disorder seeking to identify reasons for some of the dilemmas and future solutions to it. The risk-benefit profile of antidepressant medications for the treatment of bipolar depression and of atypical antipsychotics for maintenance treatment are such areas of controversial opinions among academic experts and clinicians. One of the reasons for the controversies for example is the striking incongruity between the wide use of and the weak evidence base for the efficacy of antidepressant drugs in bipolar disorder. The lack of sufficient long-term safety data for atypical antipsychotics raises concerns about its proper role in the maintenance treatment. While having many treatment options it remains also unclear to a large extend why bipolar disorder is associated with increased mortality rates that cannot be explained alone by the high suicide rates associated with this disorder.

The topics for this collection of articles have been identified among members of the editorial board of International Journal of Bipolar Disorders. Subsequently, experts with international recognition have been invited to contribute to this collection of articles. The articles have undergone the journal's standard peer-review process overseen by the Editor-in-Chief and Associate Editors.

  1. It can be argued that the controversy over paediatric bipolar disorder has been useful in highlighting the issue of bipolar disorder in youths generally. Arising out of this controversy is the recognition that...

    Authors: Anthony James
    Citation: International Journal of Bipolar Disorders 2020 8:19
  2. The issue of categorical vs. dimensional classification of bipolar disorder continues to generate controversy as it has for generations. Despite the evidence that no psychiatric disorder has discrete boundarie...

    Authors: Michael Gitlin and Gin S. Malhi
    Citation: International Journal of Bipolar Disorders 2020 8:5
  3. Somatic diseases, including cardiovascular, respiratory, and cancer diseases, are the main contributors to a shortened life expectancy of 10–20 years in patients with bipolar disorder as compared to the genera...

    Authors: René Ernst Nielsen, Pirathiv Kugathasan, Sune Straszek, Svend Eggert Jensen and Rasmus W. Licht
    Citation: International Journal of Bipolar Disorders 2019 7:12
  4. Electroconvulsive therapy (ECT) is an effective treatment for all bipolar states. However, ECT remains underutilized, likely stemming from stigma and the risk of neurocognitive impairment. Neuroimaging researc...

    Authors: Christopher C. Abbott, Jeremy Miller, Megan Lloyd and Mauricio Tohen
    Citation: International Journal of Bipolar Disorders 2019 7:11
  5. The proper place and the optimal use of antidepressants in treating bipolar depression continues to be an area of great interest and greater controversy with passionate opinions more common than good studies. ...

    Authors: Michael J. Gitlin
    Citation: International Journal of Bipolar Disorders 2018 6:25