To approach the state of the art in diagnosis and treatment of check details bipolar disorder requires a review of the current state of both research and practice. There is no doubt that bipolar disorder has been an especially important and illustrative field of research in the evolution of psychiatry. Consider the

history of the discovery of lithium. It is a classic example of an alert investigator with both basic science and clinical interests seeing the potential of an unexpected laboratory Inhibitors,research,lifescience,medical observation. Recent diagnostic research, in which controversy abounds regarding under diagnosis and misdiagnosis of bipolar disorder, illustrates the riclmess of the clinical relevance of contemporary diagnostic and nosological research. Other aspects of current research that are relevant to diagnostic validity include genetic and outcome research. With Inhibitors,research,lifescience,medical respect to treatment, there are controversies regarding the use of mood-stabilizing agents, and dilemmas in the use of antidepressant agents in bipolar disorder. In terms of theories of the pathogenesis of bipolar illness, neurobiological research and theories have advanced, with the kindling

hypothesis in particular seeming Inhibitors,research,lifescience,medical useful as a general theory of the pathophysiology of bipolar disorder. In addition, integrative research that includes attention to the psychosocial aspects of bipolar disorder appears on the verge of full development. Progress in scientific psychiatry: the central role of bipolar disorders Bipolar illness, among psychiatric conditions, has served a central role in advancing clinical psychiatry, especially Inhibitors,research,lifescience,medical the interaction of biological predisposition with environmental stress. For one thing, there is a clear genetic diathesis for bipolar illness. Also, there are six different clinical state Inhibitors,research,lifescience,medical changes

that can be studied: two states (depression and mania), and four phase changes (from depression to mania, from mania to depression, from depression to mixed states, and from mixed states to depression). These multiple clinical features of bipolar illness have served as a powerful research tool. And, as noted, there is substantial new bearing on the role of psychosocial factors in the emergence of episodes also of affective illness (eg, the kindling paradigm) and in its treatment as well. Despite the advances that have been made in research into affective illness, such progress is not necessarily smooth and rational. Unfortunately, there is also a tendency toward scientific fads, or “make-believes” according to van Praag.1 It is unfathomable why certain areas of literature simply drop out as others capture our attention and take over. For example, the relatively robust literature on electrolyte disturbances died out rather abruptly in the late 1960s for no apparent reason. Certainly, there was no rash of nonreplications to explain the curious disappearance of this trail.