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Bipolar Affective Disorder: Causes and Prevention of Relapse

Published online by Cambridge University Press:  02 January 2018

Trevor Silverstone  and
Sarah Romans-Clarkson
Trevor Silverstone*
Affiliation:
Medical College of St Bartholomew's Hospital, West Smithfield, London EC1
Sarah Romans-Clarkson
Affiliation:
Department of Psychological Medicine, University of Otago Medical School, Dunedin, New Zealand
*
∗Correspondence
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Abstract

The majority of patients with bipolar affective disorder relapse at least once during their lifetime, most several times, often with disastrous consequences. In this review we examine those factors which appear to play a facilitatory and in some cases, a causal role in determining whether a relapse will occur and, if so, when. Such factors include: the season of the year, with most admissions for mania in the British Isles occurring in the summer months; change in endocrine status, as after childbirth or when there is impaired thyroid function; treatment with drugs affecting central monoamine, particularly dopamine, neurotransmission; untoward life events. We evaluate the relative efficacy of treatments for the prevention of relapse, such as lithium, carbamazepine and antipsychotics, in the context of social and psychological support systems.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 154 , Issue 3 , March 1989 , pp. 321 - 335
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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