Such a program should involve at least three operational components:

  • Adaptation of existing screening and diagnostic tools for bipolar disorder, with a view to accounting for differences in the local presentation of the disorder and making them suitable for use by personnel in the primary care setting.

  • Pharmacological treatment, with specific guidelines for symptom control in acute episodes, maintenance of stabilization and prevention of relapse, and means of ensuring adherence to the treatment protocol.

  • Mobilization of family and community support, including providing education on the nature of the disorder and its treatment, involving the family in simple problem-solving training, and involving the local community in providing a supportive and nonstigmatizing environment.

REFERENCES

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2. E. Kraepelin. Manic-depressive insanity and paranoia. E&S Livingstone: Edinburgh, 1921.

3. C. Friddle, R. Koskela, K. Ranade, J. Hebert, M. Cargill, C.D. Clark, M. McInnis, S. Simpson, F. McMahon, O.C. Stine, D. Meyers, J. Xu, D. MacKinnon, T. Swift-Scanlan, K. Jamison, S. Folstein, M. Daly, L. Kruglyak, T. Marr, J.R. DePaulo, and D. Botstein. Full-genome scan for linkage in 50 families segregating the bipolar affective disease phenotype. American Journal of Human Genetics 66:205–215, 2000.

4. D.H.R. Blackwood, L. He, S.W. Morris, A. McLean, C. Whitton, M. Thomson, et al. A locus for bipolar affective disorder on chromosome 4p. Nature Genetics 12:427–430, 1996.

5. E.I. Ginns. A genome-wide search for chromosomal loci linked to bipolar affective disorder in the Old Order Amish. Nature Genetics 12:431–435, 1996.

6. N.B. Freimer, et al. Genetic mapping using haplotype, association and linkage methods suggests a locus for severe bipolar disorder (BPI) at 18q22–q23. Nature Genetics 12:436–441, 1996.

7. A.L. Stoll, M. Tohen, Baldessarini, D.C. Goodwin, S. Stein, S. Katz, et al. Shifts in the diagnostic frequencies of schizophrenia and affective disorders from 1972 through 1998; A combined analysis from four North American psychiatric hospitals. American Journal of Psychiatry 151:130–132, 1994.

8. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Clinical descriptions and diagnostic guidelines. World Health Organization: Geneva, 1992.

9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. American Psychiatric Association: Washington D.C., 1994.



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