Bipolar depression: the real challenge.

This paper seeks to raise awareness of the impact and burden of bipolar depression and the need to improve its recognition and management in clinical practice. Bipolar depression is commonly misdiagnosed as unipolar depression and consequently, patients may receive inappropriate treatment that could potentially worsen symptoms. The Mood Disorder Questionnaire (MDQ) is a useful screening tool for identifying the range of bipolar spectrum disorders in general and psychiatric populations. Bipolar depression has a significant impact on patients, affecting work, social activities, family and friends. Current treatments for bipolar disorder have focused on mania, yet symptoms of bipolar depression occur more frequently, last longer, are more disruptive and are associated with greater risk of suicide than mania. In comparison with unipolar depression, bipolar depression is more severe, is associated with more frequent hospital visits and causes greater psychosocial impairment. These facts emphasise the importance of improving the diagnosis and treatment of bipolar depression.