Redefining Bipolar Disorder: Toward DSM-V

摘要

We now recognize that bipolar disorder is often accompanied by anxiety, eating, and substance use disorders (1) and high rates of medical illness, especially cardiovascular, cerebrovascular, and metabolic diseases (2). Individuals with bipolar disorder also suffer from a marked disruption in sleep rhythms and social relations. Rather than defining bipolar disorder solely as one of episodic mood disturbances, we should consider defining it as a multisystem disorder involving disturbances in all of the above-mentioned domains. By employing a symptom-based rather than an etiologically based approach, DSM-IV fails to reflect the multisystem presentation of bipolar disorder.