An interesting and informative short article entitled ‘Bipolar Disorder: At The Extremes‘ and published in the highly respected British medical journal ‘The Lancet‘ (Volume 381, Issue 9878, Page 1597, 11 May 2013) summarises three papers which discuss the complexities of future psychiatry.
Nick Craddock and Pamela Sklar’s paper provides an detailed review of genetic research, focusing in on its potential to understand more fully the mechanisms underlying a very complex set of risks and vulnerabilities.
Mary Phillips and David Kupfer’s review of advances in diagnostic techniques, with an emphasis on neuroimaging, proffers the hope that in the future, advanced science might contribute to the ideal of targeted care.
John Geddes and David Miklowitz’s paper provides a comprehensive overview of the management of bipolar disorder, and in-so-doing provides a cogent and timely reminder of the multifaceted nature of treatment, where psychosocial approaches have a place alongside pharmacological ones.
Such a multidisciplinary and holistic approach encompassing genetics, advanced diagnostics and psychosocial/pharmacological factors provides the best hope for the optimal management of bipolar disorder. After all, although the clinicians tell us that the over-arching symptomatology of bipolar can be broadly categorised as type I, II, rapid-cycling etc, each individual presents with a unique combination of symptoms. It therefore follows that treatment for such a diverse group of patients should be highly specific, and although psychiatrists are very much aware of this, the tools they have available to them at the moment are somewhat limited.
You can read the whole article here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61005-3/fulltext