Bipolar disorder: etiological, clinical and therapeutic challenges
DOI:
https://doi.org/10.33448/rsd-v11i14.36224Keywords:
Bipolar disorder; Etiology; Therapeutic approach.Abstract
Bipolar Disorder is a psychiatric condition characterized by severe mood swings between the opposite poles of affective experience, involving periods of high mood and depression, interspersed with periods of remission. A literature review was carried out, which sought to highlight the main etiologies of bipolar disorder, as well as the clinical and therapeutic challenges of approach. It was seen that bipolar disorder has a multifactorial, complex and broad etiology, directly related to neurochemical changes, cellular resilience and neuroplasticity, mitochondrial disorders and chronic stress and the inflammatory character. The average age at the onset of the disorder is 25 years, but it is very common in adolescence, with an increased frequency among women. In many cases, affected people are not diagnosed until 10 years after the onset of symptoms. Also, due to the variety of etiologies and clinical profiles, the therapy for the treatment and control of bipolar disorder is based on the use of neurotransmitter regulators, anticonvulsants, as well as maintaining adequate levels of lithium in the body. In addition, after the therapy is implemented, factors such as reduced social and family support, discredit to pharmacological therapy and traditional health care culminate in low therapeutic adherence and worsening of the condition.
References
American Psychiatric Association (2014). DSM-5: Manual Diagnóstico e Estatístico de Transtornos Mentais. Edição: 5 ed. Artmed, 2014.
Bavaresco, D. V. (2018). Papel da inflamação no transtorno bipolar: avaliação de biomarcadores e eficácia de anti-inflamatório como terapia adjuvante. Tese (Doutorado) - Universidade do Extremo Sul Catarinense, Programa de Pós-Graduação em Ciências da Saúde, Criciúma.
Bosaipo, N. B., Borges, V. F. & Juruena, M. F. (2017). Transtorno Bipolar: uma revisão dos aspectos conceituais e clínicos. Medicina Ribeirão Preto, 50 (1), 72-84.
Bristot, G. (2022). Biomarcadores periféricos e regulação transcricional nos transtornos psiquiátricos: vias moleculares associadas à psicopatologia no transtorno bipolar, transtorno depressivo maior e esquizofrenia. Tese (Doutorado) – Universidade Federal do Rio Grande do Sul, Porto Alegre.
Cepp, F. B. C. (2019). Desenvolvimento de um modelo de transtorno bipolar a partir de fatores ambientais. Tese (Doutorado) – Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Farmacologia, Fortaleza.
Costa, K. M. Q.; Góes, R. M. & Morais, M. M. N. (2021). A influência dos aspectos subjetivos na adesão ao tratamento do transtorno bipolar: uma revisão sistemática. J Bras Psiquiatr, 70 (4), 330-337.
Dejong, K., et al. (2018). Pregnancy in patients with bipolar disorder: Maternal and neonatal outcomes. American Journal of Obstetrics and Gynecology, 21 (8).
Di Florio, A., et al. (2018). Stratification of the risk of bipolar disorder recurrences in pregnancy and postpartum. The British journal of psychiatry: the journal of mental science, 213(3), 542–547.
Dolman, C., et al. (2016). Women with bipolar disorder and pregnancy: factors influencing their decision-making. BJPsych open, 2(5), 294–300.
Enes, C. L. et al. (2020). Predição da adesão ao tratamento e qualidade de vida de pacientes com transtorno bipolar. Revista de Enfermagem do Centro Oeste Mineiro, 10 (8).
Freitas, M. S., et al. (2021). O transtorno bipolar: senso comum x a visão psicopatológica. Research, Society and Development, 10(12).
Imaz, M. L., et al. (2019). Clinical Lactation Studies of Lithium: A Systematic Review. Frontiers in pharmacology, 10 (1).
Kameg B. N. (2021). Bipolar disorder: Treatment strategies for women of childbearing age. Perspectives in psychiatric care, 57(3), 1244–1249.
Kapczinski, F. & Quevedo, J. (2016). Transtorno Bipolar. Grupo A.
Khan, S. J., et al. (2016). Bipolar Disorder in Pregnancy and Postpartum: Principles of Management. Current psychiatry reports, 18(2).
Larsen, E. R., et al. (2017). Pregnancy and bipolar disorder: the risk of recurrence when discontinuing treatment with mood stabilisers: a systematic review. Acta neuropsychiatrica, 29(5), 259–266.
Lorettu, L., et al. (2020). Lithium Use During Pregnancy in a Patient With Bipolar Disorder and Multiple Sclerosis. Clinical neuropharmacology, 43(5), 158–161.
Norris, T. L. (2021). Porth - Fisiopatologia. Grupo GEN.
Petkevicius, G. A. M., et al. (2020). Perfil clínico – epidemiológico de pessoas com transtorno bipolar em internação psiquiátrica. Research, Society and Development, 9(9).
Suppes, T. & Dennehy, E. B. (2009). Transtorno Bipolar. As Mais Recentes Estratégias de Avaliação e Tratamento. Artmed.
Viana, W. T. (2020). A neuroplasticidade em pacientes com transtorno afetivo bipolar. Trabalho de Conclusão de Curso – Centro Universitário de Brasília, Graduação em Enfermagem, Brasília.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Bárbara Queiroz de Figueiredo; Talita Marques da Silva; Luciana de Almeida França; Josilene Maria de Sousa; Renata Teixeira Tajra Melo Boavista; Yasmin Justine Borges
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
