The State of the Art in Diagnosis and Treatment of Soft Bipolar Disorders

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Abstract

In the past four decades there has been great controversy about the publications that have led to rethink the dimensional perspective of the bipolar disorders, suggesting a paradigm shift in their diagnosis and treatment.

Soft bipolar disorders constitute about two-thirds of all patients with bipolar disorder and refer mostly to highly frequent and recurrent switching in mood and energy (hypomania alternating with minor, major, or mixed depressive episodes). More than a half of patients with bipolar disorders have cyclothymic or hyperthymic temperaments, family history of bipolar disorders, and many of them exhibit comorbidity with anxiety disorders and personality disorders (clusters B or C).

Early detection of soft bipolar disorders in young people is essential as long as it is done in a reliable way to avoid the risk of trivialization of the disorder and the utilization of interventions that may endanger the patients. The search for biomarkers, endophenotypes, and classification systems that combine categorical items with dimensional descriptors, besides the development of clinical scales with high levels of validity and sensitivity, are essential for the proper recognition and differential diagnosis of soft bipolar disorders.

This thematic issue focuses on four aspects of the soft bipolar disorders: bipolar spectrum, temperaments, staging, and treatment.

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