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Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World
Summary of Findings: Bipolar Disorder in Developing Countries
Bipolar disorders account for about 11 percent of the neuropsychiatric disease burden and about 1 percent of the total disease burden in developing countries.
Between 25 and 50 percent of patients in developed countries with bipolar disorder are estimated to attempt suicide, and as many as 15 percent complete the act.
Predisposition to bipolar disorder may be inherited; other apparent risk or precipitating factors include substance abuse, living in an urban setting, and lack of education. The significant impact of social and environmental factors on the presentation, course, and incidence of bipolar disorder argues for increased research in developing countries.
There is no known course of primary prevention for bipolar disorder. Risk factors and the physical and psychological symptoms of the disorder can be reduced and controlled but not eliminated following diagnosis.
Treatment for bipolar disorder often requires a combination of medications, few of which have been tested in developing countries. Acute episodes of mania are best treated with antipsychotic medications or high doses of mood stabilizers; acute episodes of depression can be treated with antidepressant medication and electroconvulsive treatment.
Once acute symptoms are under control, active treatment with mood stabilizers, possibly including psychosocial interventions, must be undertaken to prevent the illness from becoming increasingly severe.