In this chapter we review research on the diagnosis, course, etiology, and pharmacological and psychosocial treatment of bipolar disorder (BD). BD is a highly recurrent and severe illness, with high rates of suicidality and functional impairment. The disorder is heritable and appears to share susceptibility genes with schizophrenia. It is characterized by dysregulation in the dopamine and serotonin systems and by pathology in the brain systems involved in regulating emotion. Psychosocial stressors, notably life events and familial expressed emotion, significantly influence the course of the illness in the context of these vulnerabilities. Findings of randomized clinical trials indicate that psychosocial interventions enhance long-term outcomes when added to pharmacotherapy. Much remains to be clarified about the interactive contributions of genetic, neurobiological, and psychosocial factors to the course of the disorder, and the moderators and mediators of treatment effects.

中文翻译：

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双相情感障碍的精神病理学和治疗。


在本章中，我们回顾了双相情感障碍（BD）的诊断、病程、病因以及药理学和心理社会治疗的研究。 BD 是一种高度复发的严重疾病，具有很高的自杀率和功能障碍。这种疾病具有遗传性，并且似乎与精神分裂症具有相同的易感基因。其特征是多巴胺和血清素系统失调以及涉及调节情绪的大脑系统的病理学。在这些脆弱性的背景下，社会心理压力源，特别是生活事件和家庭表达的情绪，会显着影响疾病的进程。随机临床试验的结果表明，在药物治疗的基础上加入心理社会干预措施可以增强长期疗效。关于遗传、神经生物学和社会心理因素对疾病进程的相互作用以及治疗效果的调节因素和中介因素，还有许多问题有待澄清。