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Introduction ‐ Bipolar Illness: Current Understanding and Future Perspectives

Bipolar disorder (BD, also known as manic-depression) is known since the era of Hippocrates and Areteus. During the last few decades, contrary to the Kraepelinian proposal, it has been documented that chronic and complex clinical pictures and not classic forms dominate the contemporary clinical practice [1–5]. The aim of this “academic supplement” was to summarize our current understanding of BD and give future perspectives; the same time to help physicians to incorporate recent research data into their clinical practice and translate them into benefits for real world patients. In the first article, Eduard Vieta et al. discuss the nature of cognitive dysfunction in bipolar spectrum patients. In the second article Heinz Grunze et al. analyze the neuroimaging data while in the third article Jean Michel Azorin et al. explore the issue of lateonset bipolar illness (BD-VI). In the fourth article Emanuel Severus et al. review the state of the art for the treatment of bipolar disorder on the basis of research data. Rasmus Licht et al. tackle the issue of lithium and its place in contemporary therapeutics in the fifth article, while I review the evidence-based treatment of the refractory bipolar patient in the sixth. In the seventh article Xenia Gonda et al. discuss the effect of pharmacotherapy on suicide rates while in the last article Charles Bowden et al. discuss the results from the pragmatic trial STEP-BD. Each of these articles deals with a separate but complementary aspect of the pathophysiology and treatment of BD with focus on special issues like refractoryness, suicidality etc. Their scope is to help the clinician to carry and incorporate advanced research findings into the everyday treatment of real world patients by clarifying findings, discussing advantages and limitations, and pointing to gaps in knowledge, which the clinician is obliged to fill with the careful use of clinical wisdom.