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Bipolar disorder - A review of current knowledge - from etiology and diagnosis to treatment
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  • Bipolar disorder - A review of current knowledge - from etiology and diagnosis to treatment
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Bipolar disorder - A review of current knowledge - from etiology and diagnosis to treatment

Authors

  • Weronika Woźnica Medical University Of Lublin https://orcid.org/0009-0007-1549-7290
  • Julia Dąbrowska Medical University of Lublin, Poland https://orcid.org/0009-0000-5273-5031
  • Michał Białogłowski Casimir Pulaski Radom University https://orcid.org/0009-0002-8664-0545
  • Katarzyna Mazurek Stefan Cardinal Wyszynski Regional Specialized Hospital in Lublin, Poland https://orcid.org/0009-0001-4433-9001
  • Anna Gęborys Medical University of Lublin, Poland https://orcid.org/0009-0009-1062-3790
  • Maja Wojcieszak Medical University of Lublin, Poland https://orcid.org/0009-0005-7384-8605
  • Julia Matuszewska University Clinical Hospital No. 1 In Lublin, Stanisława Staszica 16, 20-400 Lublin, Poland https://orcid.org/0009-0009-6002-9335
  • Kacper Kutnik Medical University of Lublin, Poland https://orcid.org/0009-0000-5091-1302
  • Alicja Maziarczyk Medical University of Lublin https://orcid.org/0009-0001-6634-4215
  • Jakub Lambach https://orcid.org/0009-0003-6928-3037

DOI:

https://doi.org/10.12775/QS.2026.52.69550

Keywords

bipolar disorder, mood stabilizers, lithium, antipsychotics, quetiapine, lurasidone, asenapine

Abstract

Introduction: Bipolar disorder is a chronic mental illness characterized by significant and often unpredictable changes in mood and energy levels. It is characterized by periods of mania or hypomania alternating with episodes of depression. Unfortunately, it often remains underdiagnosed and difficult to treat as it requires a comprehensive approach that combines pharmacological and non-pharmacological strategies tailored to the phase and severity of the illness.  

Aim of the study:  The aim of this review is to summarize the latest knowledge related to bipolar disorder, including epidemiology, pathophysiology, clinical types, and risk factors. In particular, it focuses on diagnostic difficulties and appropriate treatment. 

Materials and methods: A comprehensive literature review was conducted using “PubMed”, Google Scholar and other databases. The following keywords were used:  “bipolar disorder”, “mood stabilizers”, “lithium”,“antipsychotics”, “electroconvulsive therapy” 

Conclusions: Bipolar disorder is a severe but underdiagnosed mental illness that poses a therapeutic challenge. The etiology is multifactorial, and the incidence is the same in women and men. Treatment should include two main components: acute treatment of mood episodes and maintenance therapy. Current treatment strategies include mood stabilizers and antipsychotic medications. Nevertheless, lithium remains extremely important, as it is the only medication with proven anti-suicidal effects. Psychological interventions and electroconvulsive therapy may be valuable adjuncts. Further research is needed to optimize treatment and improve outcomes for patients with bipolar disorder. 

References

[1] Preuss, U. W., Schaefer, M., Born, C., & Grunze, H. (2021). Bipolar Disorder and Comorbid Use of Illicit Substances. Medicina (Kaunas, Lithuania), 57(11), 1256. https://doi.org/10.3390/medicina57111256

[2] Miller T. H. (2016). Bipolar Disorder. Primary care, 43(2), 269–284. https://doi.org/10.1016/j.pop.2016.02.003

[3] Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. Lancet (London, England), 387(10027), 1561–1572. https://doi.org/10.1016/S0140-6736(15)00241-X

[4] Martinez-Aran, A., Vieta, E., Torrent, C., Sanchez-Moreno, J., Goikolea, J. M., Salamero, M., Malhi, G. S., Gonzalez-Pinto, A., Daban, C., Alvarez-Grandi, S., Fountoulakis, K., Kaprinis, G., Tabares-Seisdedos, R., & Ayuso-Mateos, J. L. (2007). Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar disorders, 9(1-2), 103–113. https://doi.org/10.1111/j.1399-5618.2007.00327.x

[5] Grande, I., Goikolea, J. M., de Dios, C., González-Pinto, A., Montes, J. M., Saiz-Ruiz, J., Prieto, E., Vieta, E., & PREBIS group (2013). Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data). Acta psychiatrica Scandinavica, 127(5), 403–411. https://doi.org/10.1111/acps.12003

[6] Tondo, L., Vázquez, G. H., & Baldessarini, R. J. (2017). Depression and Mania in Bipolar Disorder. Current neuropharmacology, 15(3), 353–358. https://doi.org/10.2174/1570159X14666160606210811

[7] Dunner, D. L., Stallone, F., & Fieve, R. R. (1976). Lithium carbonate and affective disorders. V: A double-blind study of prophylaxis of depression in bipolar illness. Archives of general psychiatry, 33(1), 117–120. https://doi.org/10.1001/archpsyc.1976.01770010073014

[8] McIntyre, R. S., & Calabrese, J. R. (2019). Bipolar depression: the clinical characteristics and unmet needs of a complex disorder. Current medical research and opinion, 35(11), 1993–2005. https://doi.org/10.1080/03007995.2019.1636017

[9] American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™(5th ed.). American Psychiatric Publishing, Inc.. https://doi.org/10.1176/appi.books.9780890425596

[10] Greenwood T. A. (2020). Creativity and Bipolar Disorder: A Shared Genetic Vulnerability. Annual review of clinical psychology, 16, 239–264. https://doi.org/10.1146/annurev-clinpsy-050718-095449

[11] Keck, P. E., Jr, McElroy, S. L., & Arnold, L. M. (2001). Bipolar disorder. The Medical clinics of North America, 85(3), 645–ix. https://doi.org/10.1016/s0025-7125(05)70334-5

[12] Sajatovic M. (2005). Bipolar disorder: disease burden. The American journal of managed care, 11(3 Suppl), S80–S84.

[13] Smith, D. J., Whitham, E. A., & Ghaemi, S. N. (2012). Bipolar disorder. Handbook of clinical neurology, 106, 251–263. https://doi.org/10.1016/B978-0-444-52002-9.00015-2

[14] Craddock, N., & Sklar, P. (2013). Genetics of bipolar disorder. Lancet (London, England), 381(9878), 1654–1662. https://doi.org/10.1016/S0140-6736(13)60855-7

[15] Anderson, I. M., Haddad, P. M., & Scott, J. (2012). Bipolar disorder. BMJ (Clinical research ed.), 345, e8508. https://doi.org/10.1136/bmj.e8508

[16] Sullivan, P. F., Daly, M. J., & O'Donovan, M. (2012). Genetic architectures of psychiatric disorders: the emerging picture and its implications. Nature reviews. Genetics, 13(8), 537–551. https://doi.org/10.1038/nrg3240

[17] Phillips, M. L., & Kupfer, D. J. (2013). Bipolar disorder diagnosis: challenges and future directions. Lancet (London, England), 381(9878), 1663–1671. https://doi.org/10.1016/S0140-6736(13)60989-7

[18] Sara, G. E., & Malhi, G. S. (2015). Trends in diagnosis of bipolar disorder: Have the boundaries changed?. The Australian and New Zealand journal of psychiatry, 49(11), 1021–1028. https://doi.org/10.1177/0004867415607987

[19] Fritz, K., Russell, A. M. T., Allwang, C., Kuiper, S., Lampe, L., & Malhi, G. S. (2017). Is a delay in the diagnosis of bipolar disorder inevitable?. Bipolar disorders, 19(5), 396–400. https://doi.org/10.1111/bdi.12499

[20] Keshavarz M. (2017). Glial cells as key elements in the pathophysiology and treatment of bipolar disorder. Acta neuropsychiatrica, 29(3), 140–152. https://doi.org/10.1017/neu.2016.56

[21] Frey, B. N., Andreazza, A. C., Nery, F. G., Martins, M. R., Quevedo, J., Soares, J. C., & Kapczinski, F. (2007). The role of hippocampus in the pathophysiology of bipolar disorder. Behavioural pharmacology, 18(5-6), 419–430. https://doi.org/10.1097/FBP.0b013e3282df3cde

[22] Steckert, A. V., Valvassori, S. S., Moretti, M., Dal-Pizzol, F., & Quevedo, J. (2010). Role of oxidative stress in the pathophysiology of bipolar disorder. Neurochemical research, 35(9), 1295–1301. https://doi.org/10.1007/s11064-010-0195-2

[23] Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive therapy and research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1

[24] Miklowitz, D. J., & Chung, B. (2016). Family-Focused Therapy for Bipolar Disorder: Reflections on 30 Years of Research. Family process, 55(3), 483–499. https://doi.org/10.1111/famp.12237

[25] Frank, E., Swartz, H. A., & Boland, E. (2007). Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues in clinical neuroscience, 9(3), 325–332. https://doi.org/10.31887/DCNS.2007.9.3/efrank

[26] Mutz J. (2023). Brain stimulation treatment for bipolar disorder. Bipolar disorders, 25(1), 9–24. https://doi.org/10.1111/bdi.13283

[27] Brancati, G. E., Medda, P., & Perugi, G. (2025). The effectiveness of electroconvulsive therapy (ECT) for people with bipolar disorder: is there a specific role?. Expert review of neurotherapeutics, 25(4), 381–388. https://doi.org/10.1080/14737175.2025.2470979

[28] Abbott, C. C., Miller, J., Lloyd, M., & Tohen, M. (2019). Electroconvulsive therapy electrode placement for bipolar state-related targeted engagement. International journal of bipolar disorders, 7(1), 11. https://doi.org/10.1186/s40345-019-0146-z

[29] Morsel, A. M., Morrens, M., & Sabbe, B. (2018). An overview of pharmacotherapy for bipolar I disorder. Expert opinion on pharmacotherapy, 19(3), 203–222. https://doi.org/10.1080/14656566.2018.1426746

[30] Nierenberg, A. A., Agustini, B., Köhler-Forsberg, O., Cusin, C., Katz, D., Sylvia, L. G., Peters, A., & Berk, M. (2023). Diagnosis and Treatment of Bipolar Disorder: A Review. JAMA, 330(14), 1370–1380. https://doi.org/10.1001/jama.2023.18588

[31] Gomes-da-Costa, S., Marx, W., Corponi, F., Anmella, G., Murru, A., Pons-Cabrera, M. T., Giménez-Palomo, A., Gutiérrez-Arango, F., Llach, C. D., Fico, G., Kotzalidis, G. D., Verdolini, N., Valentí, M., Berk, M., Vieta, E., & Pacchiarotti, I. (2022). Lithium therapy and weight change in people with bipolar disorder: A systematic review and meta-analysis. Neuroscience and biobehavioral reviews, 134, 104266. https://doi.org/10.1016/j.neubiorev.2021.07.011

[32] Martinotti, G., Montemitro, C., Pettorruso, M., Viceconte, D., Alessi, M. C., Di Carlo, F., Lucidi, L., Picutti, E., Santacroce, R., & Di Giannantonio, M. (2019). Augmenting pharmacotherapy with neuromodulation techniques for the treatment of bipolar disorder: a focus on the effects of mood stabilizers on cortical excitability. Expert opinion on pharmacotherapy, 20(13), 1575–1588. https://doi.org/10.1080/14656566.2019.1622092

[33] Baird-Gunning, J., Lea-Henry, T., Hoegberg, L. C. G., Gosselin, S., & Roberts, D. M. (2017). Lithium Poisoning. Journal of intensive care medicine, 32(4), 249–263. https://doi.org/10.1177/0885066616651582

[34] Papiol, S., Schulze, T. G., & Heilbronner, U. (2022). Lithium response in bipolar disorder: Genetics, genomics, and beyond. Neuroscience letters, 785, 136786. https://doi.org/10.1016/j.neulet.2022.136786

[35] Ochoa E. L. M. (2022). Lithium as a Neuroprotective Agent for Bipolar Disorder: An Overview. Cellular and molecular neurobiology, 42(1), 85–97. https://doi.org/10.1007/s10571-021-01129-9

[36] Rybakowski J. K. (2024). Lithium: Fifteen Years Later. Neuropsychobiology, 83(5-6), 205–213. https://doi.org/10.1159/000542490

[37] Won, E., & Kim, Y. K. (2017). An Oldie but Goodie: Lithium in the Treatment of Bipolar Disorder through Neuroprotective and Neurotrophic Mechanisms. International journal of molecular sciences, 18(12), 2679. https://doi.org/10.3390/ijms18122679

[38] Airainer, M., & Seifert, R. (2024). Lithium, the gold standard drug for bipolar disorder: analysis of current clinical studies. Naunyn-Schmiedeberg's archives of pharmacology, 397(12), 9723–9743. https://doi.org/10.1007/s00210-024-03210-8

[39] Fontana, E., Mandolini, G. M., Delvecchio, G., Bressi, C., Soares, J. C., & Brambilla, P. (2020). Intravenous valproate in the treatment of acute manic episode in bipolar disorder: A review. Journal of affective disorders, 260, 738–743. https://doi.org/10.1016/j.jad.2019.08.071

[40] Crapanzano, C., Casolaro, I., Amendola, C., & Damiani, S. (2022). Lithium and Valproate in Bipolar Disorder: From International Evidence-based Guidelines to Clinical Predictors. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 20(3), 403–414. https://doi.org/10.9758/cpn.2022.20.3.403

[41] Baldessarini, R. J., Tondo, L., & Vázquez, G. H. (2019). Pharmacological treatment of adult bipolar disorder. Molecular psychiatry, 24(2), 198–217. https://doi.org/10.1038/s41380-018-0044-2

[42] Mari, J., Dieckmann, L. H. J., Prates-Baldez, D., Haddad, M., Rodrigues da Silva, N., & Kapczinski, F. (2024). The efficacy of valproate in acute mania, bipolar depression and maintenance therapy for bipolar disorder: an overview of systematic reviews with meta-analyses. BMJ open, 14(11), e087999. https://doi.org/10.1136/bmjopen-2024-087999

[43] Hashimoto, Y., Kotake, K., Watanabe, N., Fujiwara, T., & Sakamoto, S. (2021). Lamotrigine in the maintenance treatment of bipolar disorder. The Cochrane database of systematic reviews, 9(9), CD013575. https://doi.org/10.1002/14651858.CD013575.pub2

[44] Cyrkler, M., Drabik, A., Czerwiak, K. Z., & Soroka, E. (2024). Lamotrigine: A Safe and Effective Mood Stabilizer for Bipolar Disorder in Reproductive-Age Adults. Medical science monitor : international medical journal of experimental and clinical research, 30, e945464. https://doi.org/10.12659/MSM.945464

[45] Haenen, N., Kamperman, A. M., Prodan, A., Nolen, W. A., Boks, M. P., & Wesseloo, R. (2024). The efficacy of lamotrigine in bipolar disorder: A systematic review and meta-analysis. Bipolar disorders, 26(5), 431–441. https://doi.org/10.1111/bdi.13452

[46] Hamsa, A., Karumandampalayam Shanmugaramasamy, K., Kariyarambath, P., & Kathirvel, S. (2023). Quetiapine Fumarate: A Review of Analytical Methods. Journal of chromatographic science, 61(9), 892–906. https://doi.org/10.1093/chromsci/bmac100

[47] Kowalczyk, E., Koziej, S., & Soroka, E. (2024). Advances in Mood Disorder Pharmacotherapy: Evaluating New Antipsychotics and Mood Stabilizers for Bipolar Disorder and Schizophrenia. Medical science monitor : international medical journal of experimental and clinical research, 30, e945412. https://doi.org/10.12659/MSM.945412

[48] Maneeton, B., Putthisri, S., Maneeton, N., Woottiluk, P., Suttajit, S., Charnsil, C., & Srisurapanont, M. (2017). Quetiapine monotherapy versus placebo in the treatment of children and adolescents with bipolar depression: a systematic review and meta-analysis. Neuropsychiatric disease and treatment, 13, 1023–1032. https://doi.org/10.2147/NDT.S121517

[49] Tarzian, M., Soudan, M., Alhajji, M., Ndrio, M., & Fakoya, A. O. (2023). Lurasidone for Treating Schizophrenia and Bipolar Depression: A Review of Its Efficacy. Cureus, 15(4), e38071. https://doi.org/10.7759/cureus.38071

[50] Ali, Z., Tegin, C., & El-Mallakh, R. S. (2020). Evaluating lurasidone as a treatment option for bipolar disorder. Expert opinion on pharmacotherapy, 21(3), 253–260. https://doi.org/10.1080/14656566.2019.1695777

[51] Marazziti, D., Mucci, F., Falaschi, V., & Dell'Osso, L. (2019). Asenapine for the treatment of bipolar disorder. Expert opinion on pharmacotherapy, 20(11), 1321–1330. https://doi.org/10.1080/14656566.2019.1617849

[52] Vieta, E., & Montes, J. M. (2018). A Review of Asenapine in the Treatment of Bipolar Disorder. Clinical drug investigation, 38(2), 87–99. https://doi.org/10.1007/s40261-017-0592-2

[53] Cuomo, A., Beccarini Crescenzi, B., Goracci, A., Bolognesi, S., Giordano, N., Rossi, R., Facchi, E., Neal, S. M., & Fagiolini, A. (2019). Drug safety evaluation of aripiprazole in bipolar disorder. Expert opinion on drug safety, 18(6), 455–463. https://doi.org/10.1080/14740338.2019.1617847

[54] Muneer A. (2016). The Treatment of Adult Bipolar Disorder with Aripiprazole: A Systematic Review. Cureus, 8(4), e562. https://doi.org/10.7759/cureus.562

[55] Li, D. J., Tseng, P. T., Stubbs, B., Chu, C. S., Chang, H. Y., Vieta, E., Fornaro, M., Carvalho, A. F., Solmi, M., Veronese, N., Chen, T. Y., Chen, Y. W., Lin, P. Y., & Chow, P. C. (2017). Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials. Progress in neuro-psychopharmacology & biological psychiatry, 79(Pt B), 289–301. https://doi.org/10.1016/j.pnpbp.2017.06.023

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2026-03-17

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WOŹNICA, Weronika, DĄBROWSKA, Julia, BIAŁOGŁOWSKI, Michał, MAZUREK, Katarzyna, GĘBORYS, Anna, WOJCIESZAK, Maja, MATUSZEWSKA, Julia, KUTNIK, Kacper, MAZIARCZYK, Alicja and LAMBACH, Jakub. Bipolar disorder - A review of current knowledge - from etiology and diagnosis to treatment. Quality in Sport. Online. 17 March 2026. Vol. 52, p. 69550. [Accessed 22 April 2026]. DOI 10.12775/QS.2026.52.69550.
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Vol. 52 (2026)

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Copyright (c) 2026 Weronika Woźnica, Julia Dąbrowska, Michał Białogłowski, Katarzyna Mazurek, Anna Gęborys, Maja Wojcieszak, Julia Matuszewska, Kacper Kutnik, Alicja Maziarczyk, Jakub Lambach

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