[Clinical picture and diagnosis of bipolar disorder]

Since more than one century, the illness considerably evolved. Between the extremes of full-blown manic-depressive disorder and the strictly defined unipolar depression, patients exhibit particular affective conditions characterised by complex or soft symptoms. So the actual classification encompasses 6 clinical forms with sometimes, sub-forms. In this context, an awareness of the different clinical presentations is an important issue in the daily practice, especially hypomania, cyclothymia, mixed states and affective episode with delusion. These conditions are often misdiagnosed and the bipolar trouble is under-diagnosed. Although, the lifetime prevalence of the classical manic-depressive is about 1%, current evidences indicate that the bipolar spectrum account for 5-8% in the general population. So, the public health significance of a rapid and proper diagnosis is quite essential because the treatment needs to be applied in the clinical care.