The longitudinal course of bipolar disorder

Course of illness is central to our focus on bipolar disorder due to the li felong nature of this illness in the majority of patients, in this overview we highlight areas of consensus and debate on factors that impact course o f illness. Findings on age at onset, psychiatric comorbidity, frequency of episodes, cycle pattern, rapid cycling, mixed symptoms, and precipitants of episodes including use of substances and antidepressants and lithium disco ntinuation are discussed. The diversity End range of presentation and even course of illness become quickly apparent in this review. Highlighting thes e factors rather than seeking a unifying theory should be a productive way to refine our ability to identify additive factors contributing to course o f illness for patients with bipolar disorder.