Presentation and management of bipolar affective disorders in primary care.

The author reviews four case summaries of patients presenting to her family practice within a 12 month period. Each patient presented unique features, which on careful history review, fit the pattern of bipolar affective disorder, the features of which are described. Management of these patients includes mandatory psychiatric consultation and lithium for treatment of acute mania, and prophylaxis of mania and depression. Guidelines for lithium therapy are presented.The family physician is in an ideal position to detect bipolar illness and to manage patients once stabilized on longterm lithium therapy.