Improving the Course of Illness and Promoting Continuation of Treatment of Bipolar Disorder

The course and characteristics of the different types of bipolar disorder have profound implicationsfor its long-term prognosis and treatment. Patients with bipolar I disorder are symptomatically illnearly half the time and have a high probability of relapse. Bipolar II disorder is more chronic, moredepressive, and associated with more neuroticism and emotional instability between episodes thanbipolar I. Impaired psychosocial functioning and a high risk for suicide are common to all types ofbipolar disorder. The illness can be stabilized through pharmacotherapy and by patients maintainingorderly patterns of life activities and using psychotherapy, psychoeducation, and mood charting. Adherenceto pharmacotherapy increases the duration of remission. Physicians can help improve adherenceby selecting medications with simple dosage regimens and educating patients and families aboutthe disorder and what to expect from medications.