BIPOLAR ILLNESS

Background. Within the past 5 years, several factors have altered our view of the diagnosis, prognosis, treatment, and genetics of bipolar i llness. Methods. Significant advances in these areas are reviewed. Res ults. Diagnostic changes include establishment of symptom duration req uirements that limit confusion with affective instability. Prognostic insights include the realization that illness likely begets illness an d, conversely, that adequate control is probably instrumental in impro ving long-term prognosis. Therapeutic advances are marked by the Food and Drug Administration approval of divalproex for acute mania. Conclu sions. Genetic and family studies suggest that (1) bipolar illness is a discrete condition, not related to unipolar depression; and (2) bipo lar illness may manifest a phenomenon known as anticipation (worsening of the disease with succession generations), which may be related to a specific nucleic acid abnormality.