This is an archive of past discussions about Bipolar disorder. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.
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I am looking at this sentence in the introduction of the article: "Due to poor lifestyle choices and side effects from medications, the risk of death from natural causes such as heart disease is twice that of the general population."
It should be amended to read something along these lines: "Due to common behavior patterns among those afflicted with bipolar disorder, as well as to the side effects of medications frequently used to treat the disorder, the risk of death from natural causes such as heart disease is twice that of the general population."
There are a few problems with the sentence as it stands, but the main problem is the phrase "poor lifestyle choices." This phrase is judgmental, vague, and altogether un-encyclopedic. Another problem is this: Side effects are *of* medication, not *from* medication. Another problem is this: Among whom is the risk of natural causes twice that of the general population? The answer to that question is: among sufferers from bipolar disorder. That should be included in the sentence.
Adjusted to "Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as heart disease in people with bipolar is twice that of the general population." Doc James (talk · contribs · email) 18:40, 28 January 2019 (UTC)
Semi-protected edit request on 19 February 2019
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In the Bipolar Disorder page please move the paragraph under "Causes" to the "Genetics" paragraph. Please remove the title "Causes". Please remove the first and last sentences under "causes" (please see below for reference):
Please remove the first sentence "The causes of bipolar disorder likely vary between individuals and the exact mechanism underlying the disorder remains unclear.[42]". Please remove the last sentence "Estrogen in women, has been linked to bipolar disorder.[46][47]
After these edits are done the first sentence under the Genetics title should read "Genetic influences are believed to account for 60-80 percent of the rick of developing the disorder indicating....:
Attn. Administrators: Semi-Protected Edit Request on 3/5/19 to include link for Ronald Braunstein
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Hello Fellow Wikipedian Editors: Kind consider incorporating the following text at the end of the section entitled Society and Culture
In an effort to ease the social stigma associated with bipolar disorder, the orchestra conductor Ronald Braunstein cofounded the
ME/2 Orchestra with his wife Caroline Whiddon in 2011. Braunstein was diagnosed with bipolar disorder in 1985 and his concerts with the ME/2 Orchestra were conceived in order to create a welcoming performance environment for his musical colleagues, while also raising public awareness about mental illness.[1][2]
In article nobody wrote that the true bipolar refuse the refuse and likes revenge. It's not the best to describe disorder.
I use Li2CO3 300 mgx3/day + 50 gtt clonazepam/day.
I image (i'm sure) why Hitler did that. He was refused by a Jew girl without doubt ( what happened to Jew people could have happened to Dutch people if she would have been Dutch) and then he had revenge like i would have done in a huge scale. I'm sure he left her alive to show what she caused without hitting her and to show her whom she refused. There are Hitler official pics with a young Jew girl that he helped a lot and that could have been linked with this fact. Many academics have no idea of this ill. Yes melancholy( L'infinito by Leopardi, the Moonlight sonata by Beethoven[1] and Thomas Grey elegy are the best expressions of this) and obsessive mania for death (i lost both parents when 25 within 1 year; dad died 31/12/1999 at 18,30 by brain stroke, mum after a long cancer suffering a lot), sex (i'm crazy for really born redhaired girls because more difficult to meet; like extreme sex) or cleaning-perfection (cleaning home and cemetery like a ryte; i'm able to forecast finance and other people moving easily; beyond every 6th sense) strong like irony towards others. True bipolars don't likes irony and lies. They can be very cold like the oppsite. They've many times panic crisis not because of fear but because of rage(amigdala). Most intelligent ones for instance read history like today not like in books, but considering behind all hidden powers. When somebody refuses me in main things i consider him/her lower.Grey was right in describing hidden and never seen best flowers in deep oceans. 82.53.126.175 (talk) 19:54, 21 April 2019 (UTC)
Where is it classically used other than here? A google image search only shows we use it. It is a comedy and tragedy mask. A caricature. I put a bit of effort into making this one today with four different revisions for review. --E.3 (talk) 15:18, 8 June 2019 (UTC)
I really don't think that a comedy and tragedy mask looks like bipolar disorder at all. --E.3 (talk) 15:21, 8 June 2019 (UTC)
It is still a classic image. And is used by a whole bunch of reputable organizations to illustrate this condition. Doc James (talk · contribs · email) 19:49, 8 June 2019 (UTC)
Can you please provide sources for your "classically used" comment? There are multiple people with this medical condition who are telling you it's condescending and inaccurate, and all you can say is "somebody else uses it." Let us know who does, so we can address those harmful stereotypes elsewhere, too. Straightjackets are "classically used," as well, but you don't see people using them to denote mental illnesses in the 21st century. Blackface was classically used to connote black people, and yet, it's inappropriate and racist. You are harming a community with your ignorance, and then you dismiss their real concerns with the word "classical," as if an appeal to tradition is an appropriate logical fallacy to go by. Who, specifically, uses this image? Provide the names of these "reputable" institutions who use it. ACTUAL people with this disorder have told you repeatedly you are harming them. How about no image? If you feel no change is warranted, then link the source of these reputable institutions using this image. Then, cite THAT institution as using that image, not as if it's universally accepted that bipolar people fluctuate between comedy and tragedy. Or even happy or sad. Mania and depression are NOT happy and sad. Those are NOT clinical conditions.
Names of Bipolar Disorder and Manic Depressive Illness
One of the most confusing things about this mental illness is, unfortunately, the name and classification of it.
Some people prefer to call it manic depressive illness, and it can cause harm when a person is called "bipolar". This is because the name of the illness is "bipolar disorder", so it is describing them with their mental illness, similarly to calling a person with cancer "cancer".
It would be good, I think, to mention that it is also known as "manic depressive illness". That was its official name before, and it is sometimes called that, still. It wasn't called "manic depression", so perhaps that could be changed at least. "Manic depressive illness" is an official name for it, and pertains to a person going between a manic and depressive state. "Manic depression" is a misnomer in that "manic" is describing "depression", which is not necessarily the case. They are two different mental conditions. A person can experience mania or depression. — Preceding unsigned comment added by 2601:196:8800:B860:757C:9D04:1356:B978 (talk) 19:48, 27 March 2019 (UTC)
I disagree this outdated terminology of "manic depression" is not 1. in common use, 2. accepted by the medical community, or the community at large anymore E.3 (talk) 16:35, 19 April 2019 (UTC)
There are multiple types of bi
polar, but when bipolar was known as manic depression, we only knew about the one type. Bi polar affective is now what people with manic depression would have. Another type of bipolar is schizaffective disorder which is bi polar that has done symptoms of schizophrenia. I think there are other types too. Rockchicksar (talk) 10:56, 7 September 2019 (UTC)
This is an atrocious webpage. People with bipolar stand out in society as head and shoulders above the rest. The Greek philosopher whose Republic was used by Republicans as the basis for their political party... you know.. PLATO... he was bipolar. Yeah yeah Mozart and Beethoven... the greatest composers of the most complex music form ever made... they were bipolar. But so what? Right? For awhile "Sunflowers" was the most expensive painting ever sold... the artist? Van Gogh? He was bipolar too. But let's just focus on living generations shall we? The guy that got the US out of the Great Depression? Teddy Roosevelt? He was bipolar. WWII MVP? Winston Churchill? Bipolar. The paratrooper playing "Star Spangled Banner" for all the hippies? Jimi Hendrix was bipolar. Would be spokesman of Gen X... Kurt Cobain was bipolar. Can't have Star Wars without Princess Leia. Carrie Fischer was bipolar. Like Christmas songs? Greatest selling Christmas album of all time belongs to Mariah Carey and she is bipolar. Six albums/year Kanye. Bipolar.
If I was to read this wikipedia page and not know myself what a glorious gift it is to be bipolar, I'd probably be in favor in eugenics to dispose of the genes that cause this "disorder," but I know better. Could you imagine what this world would be without the contributions of the people listed above? I can't. And oh. The greatest leader America has ever known? Abe Lincoln? He was bipolar also. Yeah we're different, but to us you're all the same. — Preceding unsigned comment added by 58.69.162.30 (talk) 13:56, 20 June 2019 (UTC)
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Please remove the image, as it adds nothing to the information, and it's furthering the stereotype that bipolar people are "dramatic." Those are drama and comedy masks. Masks, like hiding your identity. It's just condescending and has no place in an article about a medical disability. 2620:0:10FA:FD00:F4D6:8CA5:4E55:7EF2 (talk) 18:51, 25 November 2019 (UTC)
We should add a note for all mental health pages saying something like: This is an encyclopedic article, and is not a replacement for a professional diagnosis. If you feel like you need help please talk to someone, preferrably a psychiatrist, as soon as possible.— Preceding unsigned comment added by C1MM (talk • contribs) 05:20, 4 December 2019 (UTC)
This is already covered by the Wikipedia:General disclaimer which is at the foot of every page. It says "If you need specific advice (for example, medical, legal, financial or risk management), please seek a professional who is licensed or knowledgeable in that area." Whether there should be a specific disclaimer for all mental health articles is beyond the scope of this article and should be raised at Village pump (proposals). There is currently a similar discussion at VPP here, but in the past specific disclaimers have often been rejected because all articles are covered by the General disclaimer. See also this VPP discussion.--♦IanMacM♦(talk to me)06:41, 4 December 2019 (UTC)
Currently, the statement regarding Bipolar Disorder (BD) prevention is misleading and does not accurately represent the cited journal article. The journal article pertains to the research of chronic cannabis abuse, not, "the usage of cannabis", as the Wiki article currently states.
Therefore, I suggest that the sentence be changed from, "There has been debate regarding the causal relationship between usage of cannabis and bipolar disorder", to "There has been debate regarding the relationship between the abuse of cannabis and bipolar disorder."
Justification
The word, 'casual' seems to only be included because it's written within the first sentence of the referenced article's abstract. Not sure how the debate being casual is relevant.
The word, 'usage', may mislead readers to think that short-term or non-abusive cannabis use causes BD, however, no evidence is referenced in the Wikipedia article. Moreover, the largest amount of cases referenced within the cited article, have only shown cases of psychosis (not BD) linked with the abuse of cannabis; there is only a single case report described an individual patient, who exhibited observed links between a long-term abuse of cannabis and clinically diagnosed BD.[1] Additionally, the researchers found that "established vulnerability to psychosis"' and/or "lifetime of cannabis use," showed an increase in the risk of cannabis-induced psychosis. The researchers specifically noted no observed effect between recent or short-term cannabis use and psychosis.[2]
This text was added "Mood stabilizers—lithium and certain anticonvulsants such as valproate and carbamazepine—are the mainstay of treatment in acute manic episodes and long-term relapse prevention."
Yet the ref provided says "Antipsychotics are first line treatment for mania, particularly if severe"
Anderson IM, Haddad PM, Scott J (December 27, 2012). "Bipolar disorder". BMJ (Clinical Research Ed.). 345: e8508. doi:10.1136/bmj.e8508. PMID23271744.
^van Os, J. (15 August 2002). "Cannabis Use and Psychosis: A Longitudinal Population-based Study". American Journal of Epidemiology. 156 (4): 319–327. doi:10.1093/aje/kwf043.
Catatonia
Catatonia is defined as "Catatonia is a state of stupor or unresponsiveness in a person who is otherwise awake."[1] As a poor understood term better to at least define it. Doc James (talk · contribs · email) 01:33, 12 March 2020 (UTC)
"Decreased responsiveness" is so general as to be misleading (could cover delirium, dementia, grieving, alcohol or benzo intoxication) - catatonia is pretty characteristic when you see it. I want someone to click on the link and read it as the parenthetical explanation is not helpful in understanding it. Hence this parenthetical explanation as it stands is not helpful. I think I have a compromise, a footnote. Cas Liber (talk·contribs) 02:27, 12 March 2020 (UTC)
So how would you define it than? I think "decreased responsiveness in someone who is otherwise awake" is reasonable. I am not a big fan of footnotes. Doc James (talk · contribs · email) 02:30, 12 March 2020 (UTC)
Have a look now - I've treated a few cases and they're pretty characteristic when you see them. Seems to be rarer nowadays, because (I think) of the widespread use of antipsychotics such as quetiapine and olanzapine in primary healthcare. Cas Liber (talk·contribs) 02:38, 12 March 2020 (UTC)
Hi @TylerDurden8823: I'll take this review on. It's a long article, so it might take me about a week to make my first pass through. Sorry for the incredibly long wait in the GAN queue. I hope we can move through it quickly and move on to more recent things. Looking forward to the read! Ajpolino (talk) 16:17, 2 February 2020 (UTC)
Great, thank you, @Ajpolino:! I will watch closely as you make suggestions and I will implement them as I can. I'll let you know if there are any assessments that seem questionable, but I think I'm pretty reasonable on these GANs. My only ask is to refrain from failing the article as I'm working on it and to allow me a reasonable amount of time to revise the article as appropriate while we're working together. As you said, it took quite a while before someone took on the herculean task of reviewing this massive but crucial article. I would hate to go through that again if we can avoid it, so I'll try and get it passed on the first go-around here. Thanks and I'll start looking through your suggestion! TylerDurden8823 (talk) 19:26, 4 February 2020 (UTC)
Sounds good. If you think something I'm suggesting is off-base just tell me so. If we're truly at loggerheads, we'll call WT:GAN or WT:MED for a second opinion rather than send you back to the multi-month GAN queue. So far the article looks great. If you get busy and don't have time for this, there's no big rush, just let me know and we can put it on hold for as long as needed. Cheers. Ajpolino (talk) 22:12, 4 February 2020 (UTC)
Ok, made it through the article. It generally looks good. I've marked some small things that should be addressed before this article can pass the GA criteria. There's no rush, so if you need more than a few weeks, let me know and we can mark the GA review as "on hold" (which doesn't mean anything; it just indicates to editors watching the GAN queue that I haven't forgotten about you). Happy editing! Ajpolino (talk) 22:18, 9 February 2020 (UTC)
Mechanism - Manic and depressive episodes tend to be characterized by ventral versus dorsal dysfunction in the vPFC. - being neither a physician nor an anatomist, it's not clear what meaning I should be gleaning from this sentence. Is it the right vs. left activation you describe in the next sentence? Or does ventral versus dorsal dysfunction have some precise meaning? Any way you could clarify that? Even if you lose some precision by saying "manic vs. depressive episodes are characterized by dysfunction in different regions of the vPFC", that may be more meaningful to readers than it is now.
Mechanism - while no differences were found in people with bipolar depression does this contradict the paragraph above where it notes that people with BPD always have more amygdala activity than non-BPD people?
Done No, this is not a contradiction. The listed areas of the brain in this sentence (the lingual gyrus, frontal lobe, etc) are distinct from the amygdala. This is simply highlighting that people who are manic, depressed, or euthymic with bipolar disorder have differing activities in certain brain regions, but this does not contradict the note about the amygdala. TylerDurden8823 (talk) 05:42, 3 March 2020 (UTC)
@TylerDurden8823: perhaps you could clarify the sentence then. I understood the way it is currently written to mean that people with BP have (relative to non-BP people) decreased lingual gyrus activitiy in euthymia, decreased inferior frontal cortex activity in mania, and no difference in activity of any brain region during depression (which seemed at odds with the above that they have increased amygdala activity all the time and decreased activation of the left vPFC during depressive episodes). But from what you said above, it sounds like you're intending to mean that people with BP have the first two things from the list, but no change in the lingual gyrus or inferior frontal cortex during depression. Is that correct? Ajpolino (talk) 16:42, 3 March 2020 (UTC)
Okay, so I looked through the cited 2011 review. People with bipolar disorder (relative to healthy control/people without bipolar disorder) have increased activity in medial temporal lobe structures (e.g., parahippocampus, amygdala, hippocampus), putamen, caudate, and pallidum. Note-this is consistent with the sentence you alluded to that discusses amygdala hyperactivity-this does indeed appear to be present in people with bipolar disorder relative to people without bipolar. Now, the same meta-analysis done by the authors also showed decreased activity of the inferior frontal gyrus and putamen (yes, I know I mentioned putamen in both lists-it probably depends on whether the person with bipolar is in a manic, depressed, mixed, or euthymic state).
The review goes on to say this-euthymic bipolar vs people without bipolar: decreased activation in the lingual gyrus. People with bipolar mania had decreased activation of the inferior frontal gyrus relative to people without bipolar disorder. The meta-analysis did not find any consistent results for a specific brain area that uniquely had increased or decreased activity relative to healthy controls. Hopefully, that clears that up a bit. I'll see if I can make the sentence clearer to convey these points. I added another paragraph at the beginning based on that review that hopefully lays a little more of the foundation/context to make things a bit clearer as well. TylerDurden8823 (talk) 04:22, 4 March 2020 (UTC)
Mechanism>Neurochemical (2nd paragraph) - The increase in GABA... makes it sound like we should already be aware that GABA increases by this point in the article (which I don't think we are?). Could you clarify why that is, or just clarify in the text that we also know that GABA increases?
Done I agree this seemed to come out of nowhere. I looked through the cited 2001 review and couldn't find verify the material. I also can't seem to find a ton of contemporary reviews (I found just a few) discussing brain GABA levels and bipolar disorder. I trimmed the sentence since it's confusing and doesn't seem to add much. TylerDurden8823 (talk) 04:26, 6 March 2020 (UTC)
Mechanism>Neurochemical - There's a {{Verify source}} tag with a comment. Can you look into it?
Diagnosis>Bipolar spectrum - There is speculation as to whether this condition may occur with great frequency in the general, untreated population... substantial emotional dysregulation could use a reference.
Done-I am unable to find a specific reference that speculates about unipolar hypomania in this way (if someone can find one that says something like this and adds it later, that's fine). TylerDurden8823 (talk) 01:43, 10 March 2020 (UTC)
History - There is a {{Verify source}} tag with a comment. Can you look into it?
Done- I am unable to find anything corroborating the specific piece about the Paris Psychiatric Society. Therefore, I removed it. If someone else finds a source that clearly supports that particular aspect of it, I would have no objection. TylerDurden8823 (talk) 01:02, 10 March 2020 (UTC)
Otherise, this looks great and meets the GA criteria. I'm glad to see such a large article cleaned up. Thanks again for the read. Happy editing. Ajpolino (talk) 23:00, 2 March 2020 (UTC)
A. The prose is clear and concise, and the spelling and grammar are correct:
•Lead - "The elevated mood is signficant..." I'm not sure if "significant" has a specific meaning in the clinical world, but to a normal reader, I don't think "the elevated mood is significant" will have any meaning. Could you rephrase to get your intended meaning across? Alternatively, it looks like if you cut "is signficant, and" from that sentence it would still make sense. Your call.
Done The term significant definitely has meaning in the clinical world (though what that meaning is might differ depending on whom you ask). I tried rewording it to "greater than expected". Does that seem clearer? TylerDurden8823 (talk) 19:42, 4 February 2020 (UTC)
"Greater than expected" is still confusing since I'm not sure what I would be expecting... I assume the purpose of the sentence is to introduce the two diagnostic levels of mania. So how about replacing the sentence with something like "If the elevated mood is severe or associated with psychosis, it is called mania; if less severe, it is called hypomania." Does that communicate what you're trying to say? I'm not at all wedded to that wording, so let me know what you think.
•Lead - "These difficulties occur a quarter to a third of the time, on average." - It's unclear if you mean 1/4 to 1/3 of people experience difficulties, or people with BD have difficulties during 1/4 to 1/3 of their lives. Could you clarify that sentence somehow?
Done After looking at the sourced review article, it appears this means ~1/4-1/3 of people with bipolar disorder experience these functional problems, not 1/4-1/3 of the time in their lives. I adjusted the wording for clarity. TylerDurden8823 (talk) 19:42, 4 February 2020 (UTC)
•Signs & symptoms - Is there another word or wikilink for "psychomotor activity"? I assume to a layreader it sounds like something only X-Men could do...
Done That's a tougher one to simplify into lay language (at least concisely). Psychomotor agitation is wikilinked for further explanation for the reader. It's basically the amount of physical movement a person has as influenced by their mood (agitated/manic --> constant fidgeting vs depressed --> abnormally slowed movements despite being physically capable of moving faster). I revised this (I can work on it more if needed) but hopefully this is clearer. TylerDurden8823 (talk) 19:48, 4 February 2020 (UTC)
•Signs & symptoms - "Mania is distinguished from hypomania by..." by whom? Presumably some diagnostic reference manual?
•Causes - You mention bipolar "type I" and "type II" are the same as the "Bipolar I disorder" and "Bipolar II disorder" mentioned later in the diagnosis section? If so, could you wikilink them (and maybe even use the same terminology) in the causes section? If not, could you clarify what they are (the words "type I" don't appear outside that section).
•Causes - You redefine the abbreviation BPD (which you'd already defined in the lead) and then use it just once. For the rest of the article you spell out "bipolar disorder". I'd suggest you either don't bother re-defining the abbreviation, or just change that one instance of "BPD" to "bipolar disorder" and the whole article will be consistent...
Done-fixed.
•Causes - Does "Major unipolar depression" = Major depressive disorder? If so, could you wikilink it here? To an uneducated reader it might sound like it's some distinct and new disorder. If it's not the same, maybe you could put an appropriate wikilink or something?
Done Yes, major unipolar depression is the same as major depressive disorder. I have adjusted this section for consistency and just switched it to major depressive disorder to avoid confusion and increase consistency throughout the article. TylerDurden8823 (talk) 20:48, 4 February 2020 (UTC)
•Causes - "Estrogen in women has been linked to bipolar disorder" seems to give almost no information. Since you say above that men and women experience bipolar disorder at similar rates, I assume estrogen isn't causatively linked in any way. So could you clarify what the linkage is (or if there's not enough clear on the topic to justify more words, you could cut it as undue...)?
Done I have cut it for now. I looked at the articles cited and it's a very interesting topic but seems too preliminary for inclusion in the article at this time. TylerDurden8823 (talk) 06:23, 9 February 2020 (UTC)
•Causes - "were initially successful in a meta-analysis..." The word "successful" doesn't seem to make sense here. Can you rephrase it somehow?
•Causes>Genetic - Maybe "Findings point strongly to heterogeneity, with different genes being implicated in different families.[57] Robust and replicable genome-wide significant associations showed several common SNPs, including variants within the genes CACNA1C, ODZ4, and NCAN.[42][51]" should be moved up earlier in the section? It's mostly discussed two paragraphs earlier, so it's confusing when the topic of GWAS associations reappears here.
•Mechanism>Physiological - Ok, I found this section pretty fragmented and challenging to read. I made a few wording tweaks to the beginning and end of the first paragraph to clarify what I think the intended meaning was. Please take a look, make sure I didn't mess up anything, and edit as you see fit.
•Mechanism>Physiological - In the first paragraph you indicate that vPFC activity could be a mood marker, while amygdala hyperactivity could be a trait marker. In the second paragraph you indicate that both could be trait markers. Can you clarify this somehow?
Done I trimmed some of the material that I agree was pretty confusing to read and difficult to tell if it was internally consistent. Hopefully, this update is clearer for readers and easier to follow. TylerDurden8823 (talk) 08:14, 28 February 2020 (UTC)
•Mechanism - In general, the mechanism section reads like a laundry list of disconnected hypotheses and facts. Is there anything you can do to clarify this section? In its current state I'm not sure who it would be of use to. If you don't have time to do this right now, I can try to help (though I'm no neuroscientist), and/or we can try to recruit a neuro/med/molecular biology person to help out.
•Diagnosis - "to rule-out medical causes" - Reads weird to a non-physician. Maybe just "other" causes? Or "non-psychiatric" causes?
•Lead - "the risk of death from natural causes such as coronary heart disease in people with bipolar is twice that of the general population" I don't think this appears in the body of the article (though maybe I've missed it?). A very brief discussion of this in the article proper would be nice.
A. It contains a list of all references (sources of information), presented in accordance with the layout style guideline:
•Management>Psychosocial - "...recognizing prodromal symptoms before full-blown recurrence, and, practising the factors that lead to maintenance of remission" has an unclear citation, a full citation needed tag, and then cites two books without page numbers to clarify. The sentence is pretty general, so hopefully you can easily find a better reference?
Done I have replaced the citation needed template and incomplete/vague references with an updated reference and reworded the sentence a bit but basically with the same meaning. TylerDurden8823 (talk) 06:41, 27 February 2020 (UTC)
•Signs and symptoms>Hypomanic episodes - There should be a reference at the end of the first paragraph to verify that some with hyomanic episodes "are irritable or demonstrate poor judgment."
•Diagnosis - "Semi structured interviews such as the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) and the Structured Clinical Interview for DSM-IV (SCID) are used for diagnostic confirmation of bipolar disorder" could use a reference.
Sorry for butting in but there is a problem - File:Bipolar mood shifts.png - (a) this image has no source, and (b) it potentially misrepresents the condition. They key feature is that it has discrete episodes characterised but interepisode absence of symptoms - the graph does not show that. Cas Liber (talk·contribs) 00:33, 4 March 2020 (UTC)
That's okay, Cas. @Casliber:, I want the article to improve so all feedback is welcome to achieve that. Can you clarify for me what you mean that the linked picture has no source? I do appreciate your second point (do you have an alternative picture you would propose for use in its place?). Something more like this [2] or [3] what you had in mind? TylerDurden8823 (talk) 22:40, 10 March 2020 (UTC)
Also, while we're on the subject of images for the article, what do you think of this one [4] for the neurochemical section? It might make things a little bit easier since describing various parts of the brain can feel abstract to people not well-versed in neuroscience. TylerDurden8823 (talk) 22:48, 10 March 2020 (UTC)
Okay - the problem with the File:Bipolar mood shifts.png is that I can't see the well (euthymic) interepisode functioning. What I mean about sources is that there needs to be a source for where the information came from on the page. For instance, the neuroscience one (need to read that article and digest) is sourced from the paper. Many graphs are sourced from textbooks/review articles/etc. so they need to me mentioned. So a textbook would be great. I am sorting now as I can 100% guarantee someone will quiz us on this at FAC (which is where I want to take this). I will try to think of a source... Cas Liber (talk·contribs) 07:13, 11 March 2020 (UTC)
Well, it looks like the image you're referring to came from Osmosis, didn't it? I understand (and agree with) your point about the noteworthy absence of clear episodes of interepisode remission as an important shortcoming of that particular image. What are your thoughts on some of the other images I linked to above? I realize they're not in English (I realize that's not ideal for an English Wikipedia page), but they do demonstrate interepisode remissions more clearly. I understand this may come up in FAC and I agree that is where we should take this eventually. This is the last single thing I see on the GA review so I'm hoping we can solve this last point so we can free up the GAN page a bit since they're getting backed up. Admittedly, this part about images is a bit outside my wheelhouse. Thanks! TylerDurden8823 (talk) 20:41, 11 March 2020 (UTC)
Hi all, I'm glad to see the attention this article has received over the last week or so. I think this now clearly meets the GA criteria so I'm going to mark it as a pass. Thanks all for the interesting read. Since several of you have expressed an interest in improving this article further, I've included some minor comments from a non-physician reader's perspective. Take em or leave em:
Signs & symptoms - their content and nature is consistent with the person's prevailing mood is so vague as to be unhelpful.
@Casliber:, is there any way you can perhaps make this piece a bit clearer for a general audience? Since you added this part, I don't want to assume what you were trying to say. TylerDurden8823 (talk) 06:28, 13 March 2020 (UTC)
Still thiking on this - wht it means in essence is - manic mood often have delusions that are euphoric/grandiose/religiose, while depressed poeple have delusions about parts of their body being dead, having cancer or owing alot of money to the tax department. Tired now, need to sleep but will sort tomorow. Cas Liber (talk·contribs)
Signs & symptoms - According to the DSM-5 criteria... more than a week the verb "requires" is a little confusing to read. Perhaps it's be clearer to say something like "According to the DSM-5 criteria, manic symtoms lasting at least four days are termed "hypomania" while symptoms lasting a week or more are called "mania"."
Causes - The overall heritability of the bipolar spectrum has been estimated at 0.71 Is there a different way to express this number that's more intuitive? I think this sentence will be essentially meaningless to non-biologists. After skimming our article on heritability perhaps the answer is no...
The first paragraph of the mechanism section is much-improved. A gold sticker to whoever wrote it (apologies for not checking the very active history more thoroughly). The rest of the section could use more structure and context to be clear to a non-expert. It still, at times, reads like a list of facts and citations.
"Medical cause" is used throughout to mean "non-psychiatric" cause (I think). I don't think this division is clear to non-clinicians, most of whom would probably consider psychiatric disorders to be "medical".
Rapid cycling - and is found in a significant proportion of individuals with bipolar disorder this is basically meaningless as written. Does significant mean it's statistically associated with bipolar disorder? Or that a substantial portion of people with bipolar disorder have it? If so, how substantial?
Fixed-I have clarified what is meant by "significant proportion" by adding more specific statistics with a supporting (and recent) secondary source for reference. TylerDurden8823 (talk) 02:25, 13 March 2020 (UTC)
Medication - ...or those with more psychotic symptoms or a more schizoaffective clinical picture not clear what this means.
I reworded a bit. Hopefully this is clearer. I'm not sure what is unclear about more psychotic symptoms but the schizoaffective clinical picture is referring to schizoaffective disorder, which has a bipolar subtype that can have some overlap with bipolar disorder. TylerDurden8823 (talk) 06:16, 13 March 2020 (UTC)
Prognosis - The standardized mortality ratio from suicide in bipolar disorder is between 18 and 25. Standardized mortality ratios won't be quickly understood by non-specialists, but Standardized mortality ratio makes it sound like this means someone with bipolar disorder is 18 to 25 times more likely to die by suicide than a member of the general population? If that's correct, perhaps phrasing it that way would be more meaningful to most readers.
The first paragraph of the Society & culture section feels like arbitrary examples of people describing their bipolar disorder in some medium. If these are really notable cases, perhaps that could be clarified somehow?
@Ajpolino:-I have added a transition sentence to try to make this feel a bit smoother diving into this discussion, but I'm not sure I understand the problem. Can you elaborate a bit on what you feel is missing and why these examples feel arbitrary? TylerDurden8823 (talk) 06:35, 13 March 2020 (UTC)
@TylerDurden8823: Yep, sorry I should have been more clear. The section begins by noting that people with bipolar disorder face social stigma and prejudice. So it felt a bit random when the rest of the paragraph was four disconnected examples of individuals' descriptions of their bipolar disorder. Were these four examples important in changing society's understanding of the disorder? Were they key cases that brought the disease into the public eye? Are they just in this article because the editors who wrote An Unquiet Mind, Chris Joseph (autobiographer), Stephen Fry: The Secret Life of the Manic Depressive, and Ronald Braunstein popped over to this article to add a link? It's unclear to an uneducated reader (such as myself). If these are significant examples, maybe that could be somehow clarified? If not, maybe they could be replaced with other material. For example, at Parkinson's_disease#Society_and_culture, it looks like three notable cases are mentioned in the section with some context and independent sources, while other cases in notable people were collected at List of people diagnosed with Parkinson's disease. Ajpolino (talk) 16:07, 13 March 2020 (UTC)
This is a good point - it is often hard to craft sections such as this as it can be hard to find encompassing views etc. Also people add material they feel is notable and I often think twice before removing it. Will see what we can do. Cas Liber (talk·contribs) 20:42, 13 March 2020 (UTC)
@Ajpolino:, okay, I understand what you mean now. Cas & I will look into it further to see if we can find sources that discuss whether these particular examples (or others) changes society's views on bipolar disorder or whether this is actually an example of just a bunch of random (though famous) names added in as noteworthy people who have the disorder. TylerDurden8823 (talk) 05:31, 14 March 2020 (UTC)
@TylerDurden8823: It's somewhat better, though the dividing line between advocacy and notable cases is somewhat unclear (since most of Advocacy is about a notable case). For what it's worth, I think the section would be enriched by more focus on stigma, societal perceptions, et al. and less focus on certain individual cases. A quick search on Google/GScholar suggests there are some papers on stigma and bipolar disorder. That said, I'll defer to the more experienced article-crafters here on what's necessary to see the article through an FA nomination. Great to see all the work post-GA status! Let me know if there's anything I can do to help! Ajpolino (talk) 02:19, 18 March 2020 (UTC)
Sure, no problem. I was modeling after the PD but I'm happy to expand on the stigma and societal perceptions piece in the advocacy section. That's easy enough. With that said, I would encourage a re-read of the advocacy section. It is mentioning famous examples of bipolar disorder, but specifically within the context of how they have been taking actions to destigmatize bipolar disorder and change the conversation. That's really where the emphasis is in that subsection. The notable cases subsection basically just mentions other celebrities who have been public about their diagnosis and says nothing about advocacy efforts so that seems like a rather clear distinction to me. TylerDurden8823 (talk) 02:59, 18 March 2020 (UTC)
I'm aware of the suggested section order at Wikipedia:Manual_of_Style/Medicine-related_articles#Diseases_or_disorders_or_syndromes, but my opinion (for what it's worth) is that the section on "Specific populations" would fit better in the article higher up with the other medical sections, perhaps after Prognosis. Finding it after History and Society & culture is a surprise to read.
How does it fit between "prognosis" or "epidemiology"? We could split these details out to other sections of this article and than remove the sections themselves. Doc James (talk · contribs · email) 19:09, 12 March 2020 (UTC)
Otherwise the article reads nicely to me. If you'd like me to read through it again in the future for clarity, let me know. Otherwise, I'll stay out of your hair. Thanks again all for the interesting read. It was a pleasure to see so much work go into this article. Happy editing! Ajpolino (talk) 06:19, 12 March 2020 (UTC)
Sorry I'm just starting to use this platform and didn't realize my refs wouldn't copy from the Sandbox. It is from a review by Smoller & Smoller on twin and adoption studies. The estimates they give are 59%-87%. doi: 10.1002/ajmg.c.20013
Ref:
Smoller, J. W., & Finn, C. T. (2003). Family, twin, and adoption studies of bipolar disorder. American
Journal of Medical Genetics, 123C, 48–58. doi: 10.1002/ajmg.c.20013 Arpgurp (talk) 21:23, 13 April 2020 (UTC)
I think the Cost subsection would go better in Epidemiology than Society and culture section.
That's fine. I don't have a strong objection to that. I just modeled it after Parkinson Disease's FA per Ajpolino's suggestion in the GA review and that one was under the society & culture section. But, either way sounds fine. TylerDurden8823 (talk) 11:47, 17 March 2020 (UTC)
Hmm, Doc James thinks otherwise. I don't care strongly enough about it to make a big deal as I can see cases for either location. Happy to wait till FAC and go with consensus there. Cas Liber (talk·contribs) 04:22, 19 March 2020 (UTC)
I agree. I don't feel strongly about it. If the community has a strong consensus one way or the other, I wouldn't vociferously object. TylerDurden8823 (talk) 06:02, 19 March 2020 (UTC)
I am in two minds about ditching all reference to ultrarapid cycling bipolar -after its definition in 2003, it is mainly mentioned in case studies (see material since 2016) and is not in DSM-5.
I actually think this sounds reasonable. I basically see nothing written about it on PubMed within the last 5 years beyond just a handful of case reports, as you said. I don't see any recent secondary sources discussing the topic, which raises serious concerns for me about how well-accepted it is among the psychiatric community (though I imagine you're more familiar with that than I am). TylerDurden8823 (talk) 16:08, 20 March 2020 (UTC)
The children and elderly sections have old sources and some editorialing - I'll try and find later sources and see how they hold up.
update - I found this which looks good. Need to sleep as after m idnight here in Oz. Will add later. Interesting review actually. Cas Liber (talk·contribs) 13:17, 18 March 2020 (UTC) added. The neuroimaging in the paper sits on the fence a bit so left out for the moment. Cas Liber (talk·contribs) 05:37, 19 March 2020 (UTC)
Okay, regarding the claim made by this that it is no longer controversial...strikes me as a trifle...ambitious. I need to digest some material on that and get consensus. But what is good is the graph on page 4 of the moods over time - more what I was thinknig (i.e. variations in the normal mood range to emphasise it is a episodic illness Cas Liber (talk·contribs) 05:40, 19 March 2020 (UTC)
Yes, I already emailed the primary author about the image to see if they will allow us to use it for the page. Can you elaborate a bit more on why you feel the claim about bipolar in children no longer being controversial is, well, controversial (or ambitious)? Is it a concern about the source? It was recommended to me by a Child and Adolescent psychiatry colleague and does appear to be written by reasonable experts (first author from UPMC I believe). Other sound contemporary sources, which I'm happy to add since I wasn't finished with that section yet, (e.g., [5], [6], [7] [this reference explicitly says the controversy has dissipated and was written in 2017] ) seem to also treat the diagnosis as uncontroversial as to whether it exists in the pediatric population (unlike the older 2008 paper currently cited in the article). I do see some ongoing controversy, as of 2017, about pediatric mania [8], but not about whether bipolar disorder occurs in children. TylerDurden8823 (talk) 06:17, 19 March 2020 (UTC)
It is a fiddly topic area for many reasons - best not to go into detail here, but despite the discrepancy between what psychiatrists think and what is published, we have to go with reliable sources. Hence I would posit that there are controversial aspects in its incidence and (likely over)diagnosis but will just take an extra look at literature and see where we can roll with it. Cas Liber (talk·contribs) 23:18, 19 March 2020 (UTC)
Well, it wouldn't surprise me if there are certain aspects of it that are controversial such as its specific incidence (I do see that there are variable estimates and we do reflect that), but its existence specifically doesn't seem to be particularly contentious at this point based on the preponderance of recent sources that seem to indicate otherwise. I'm not ruling out the possibility that some child & adolescent psychiatrists don't believe it, but it doesn't seem to be the mainstream view from what I can see so far. If a sizable portion of CAPs don't think it's real or think it's vastly overdiagnosed, that seems like something I would expect to find published (at least somewhere). I'll do another sweep of the literature soon and incorporate some of the aforementioned articles to strengthen the sourcing in the meanwhile. TylerDurden8823 (talk) 23:34, 19 March 2020 (UTC)
Right, one of the long-term issues in adult and child bipolar disorder is the concept of mood swings. In lay-terms it is used to mean Emotional dysregulation (i.e. over seconds/minutes/hours), generally seen in personality disorder and elsewhere. However it is also used to describe the (months-long+) swings between manic and depressive phases in bipolar disorder. I have had to clarify this often IRL. This Disruptive mood dysregulation disorder is a new diagnosis (and not uncontroversial) that covers kids with frequent outbursts. Its criteria are quite different to BD and epidemiologically seemingly unrelated. More later. Cas Liber (talk·contribs) 20:41, 21 March 2020 (UTC)
Casliber, the first author of the chapter and image we discussed that better demonstrates the mood swing pattern of bipolar disorder replied to my email and has given us permission to use the image on Wikipedia. He said he thinks IACAPAP would likely want to have the chapter cited (doesn't seem problematic to me at all) and otherwise said yes. Is there anything else we need to do in order to use the image? I'm unfamiliar with the process for using an image in this manner. I'm wondering if you know. If not, I'll ask around to clarify if any other steps need to be taken. Thanks! Also, nice edits today! TylerDurden8823 (talk) 05:33, 26 March 2020 (UTC)
Can do this either of two ways - either get the person to upload a copy of the image, or make a replica of the image and cite the source. Either would work. Cas Liber (talk·contribs) 06:14, 26 March 2020 (UTC)
Dilemma
None of the Physiological section is sourced to review material, just loads of primary source articles (metaanalyses are primary sources, though good ones). There are diverse findings, but none have any real traction in review articles or clinical practice (well, HPA axis stuff maybe has some traction). Question is - do we remove all as non-secondary (as I can't see any recent secondary sources referring to any of this), or leave the section as it (sort of) qualifies as "research" and hence is not "clinical medicine" Cas Liber (talk·contribs) 12:13, 26 March 2020 (UTC)
My understanding has always been that systematic reviews and meta-analyses were regarded as secondary sources here on Wikipedia [9]. Is that not the case? If so, can you show me where it says that for my future reference? Also, I see several secondary sources in this section. TylerDurden8823 (talk) 04:58, 27 March 2020 (UTC)
Sorry, my bad. Just went looking and found contrary. Okay. The section still needs some going over and reordering. And is more about neuroanatomy than physiology for starters. The HPA probably has the greatest general discussion and is at the bottom, and the dopamine material likewise. Cas Liber (talk·contribs) 20:55, 27 March 2020 (UTC)
Okay - I've done this as none of the theories have widespread consensus and none have any influence in clinical practice whatsoever. We have a large number of proposed different theories - the section is large. Now to look to see if it can be rationalised at all - the neurochemical theories have greater traction so are better up the top but musing on how to restructure/reword....Cas Liber (talk·contribs) 13:50, 14 April 2020 (UTC)
Then we have review articles like this and this which list even more hypotheses. We haven't even covered inflammatory markers...but then again they were talked about around 5-10 years ago and seem forgotten now. All the material in this section is from references dated 2004-2014 as is. Cas Liber (talk·contribs) 13:58, 14 April 2020 (UTC)
The main image on this page does a disservice to those with bipolar and those who are trying to learn more about it as doesn't accurately represent the illness. Masks imply that the behavior expressed by those with bipolar is an act. It is not. This image appears to be just clip art and does not add to the quality of the page. ScoutHarris (talk) 16:53, 17 July 2020 (UTC)
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bipolar disorder is a syndrome that causes mental illness like depression, loss in appetite and many other symptoms and it is claimed that Indian actor sushant singh rajput had bipolar disorder for his suicide, Investigation are going on regarding actors death.--Sindhuja117 (talk) 17:26, 10 August 2020 (UTC)
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delete "a comorbidity" in the sentence below
"Anxiety disorders occur more frequently a comorbidity in mixed bipolar episodes than in non-mixed bipolar depression or mania." WeedCandy (talk) 18:48, 27 March 2021 (UTC)
Partly done:Comorbidity "is the presence of one or more additional conditions often co-occurring with a primary condition." therefore the vocabulary seems appropriate. I've corrected the sentence though. RandomCanadian (talk / contribs) 18:56, 27 March 2021 (UTC)
Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 26 April 2019. Further details are available on the course page. Peer reviewers: Tmatkins19, Mojoad33.
Delete as speculative and factually inaccurate statements: “Substance (including alcohol) abuse also follows this trend, thereby appearing to depict bipolar symptoms as no more than a consequence of substance abuse.[40]”
Lamotrigine should be added to the anticonvulsants that treat bipolar disorder in the introduction.
As the title says, lamotrigine which is a mood stabiliser and is also an anticonvulsant, should be added to the list of medications that are listed in the third paragraph. Lamotrigine has already been written in the mood stabilisers section, so it should be also be written in the third paragraph.
I suggest that it be rephrased like so:
Mood stabilisers — lithium and certain anticonvulsants such as valproate, carbamazepine and lamotrigine as well as atypical antipsychotics such as aripiprazole — are the mainstay of long-term pharmacologic relapse prevention.
UnbakedBeans (talk) 13:56, 11 February 2022 (UTC)
I believe that the phrase "abnormally-elevated mood" is incorrect; adverbs that end in "-ly" should not be hyphenated. Instead, I think it should be "abnormally elevated mood".
I'm unable to find any references to the text Manicdotes by Joseph C. At one point in 2012 there was reference to the book and the author in =Society and Culture= where it said
"In his autobiography Manicdotes: There's Madness in His Method (2008) Chris Joseph describes his struggle between the creative dynamism which allowed the creation of his multi-million pound advertising agency Hook Advertising, and the money-squandering dark despair of his bipolar illness."
It's no longer in the section, and seeing how the article has gotten to GA status should the section put the information to keep the cited text, or remove [cited text]? Estoytranquile (talk) 08:58, 1 July 2022 (UTC)
Neurochemical research
Hi! I have been doing some reading on the neurochemistry of bipolar disorder. There was an interesting chapter in this book The Bipolar Brain: Integrating Neuroimaging and Genetics that proposed decreased N-acetyl aspartate levels (chapter 5) as markers for mitochondrial dysfunction and suggests that insufficient energy supply from mitochondria may lead to "neuronal malfunction", to put it broadly. I haven't seen much about this on the Bipolar page and I'm wondering if anyone would be interested in working on building this subject/section together. Kazamzam (talk) 17:24, 18 July 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 January 2023 and 5 May 2023. Further details are available on the course page. Student editor(s): Mr.huey.freeman (article contribs).
Cost: Issues with presentation and organization of Society & Culture Section
At this moment in time this is the maximum amount of time I can put into this issue, but biased information should never be presented without at least comment. I / OG poster will not be able to effect these changes immediately.
the Cost section of this article Bipolar Disorder (marked as a "good" article overall, though this should probably be rated as "fair") is not only stated first before any other aspects of society and culture concerning bipolar disorder (rather a cynical and might I say verging on eugenist establishing of the worth and value of bipolar people – especially in relation to their status as disabled), but it also fails to list any costs incurred by bipolar people themselves, the intensely disabling effect of an underfunded healthcare structure, lack of access and enforcement to ADA protections (especially within the workforce), higher rates and risks for police, intimate partner and institutional violence & abuse, the costs associated with discrimination generally, comorbid and concurrent health issues (eg: having bipolar disorder makes taking care of yourself as a diabetic additionally challenging for a wide variety of reasons). In fact this subsection is intensely slim on any actual information about the cost of bipolar disorder (even if it were to serve as merely an introduction to the topic). Lastly, the immediately following subsection is Advocacy...surely even were this Cost-first ordering maintained (inadvisable) it is intellectually dishonest to not discuss the issues which lead to the need for advocacy, many of which have to do with...cost, and cost as a reflection on the general treatment of bipolar and disabled people in society and culture. This subsection should be moved to the bottom of the section of society and culture and marked as biased, under-researched and incomplete, or removed for revision and expansion.
In summary, the presentation of disabled people primarily as a burden and secondarily as people within society via the organization of the Society and Culture section is discriminatory in its framing. The subsection regarding the cost of bipolar disorder within society itself is grossly underdeveloped, biased and promotes discriminatory thinking towards disabled people. The section should be moved to the bottom of the section and marked as biased, marked as incomplete/lacking research & information, or removed altogether. 47.184.125.109 (talk) 12:23, 3 May 2023 (UTC)
Semi-protected edit request on 3 May 2023
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the Cost section of this article Bipolar Disorder (marked as a "good" article overall, though this should probably be rated as "fair") is not only stated first before any other aspects of society and culture concerning bipolar disorder (rather a cynical and might I say verging on eugenist establishing of the worth and value of bipolar people – especially in relation to their status as disabled), but it also fails to list any costs incurred by bipolar people themselves, the intensely disabling effect of an underfunded healthcare structure, lack of access and enforcement to ADA protections (especially within the workforce), higher rates and risks for police, intimate partner and institutional violence & abuse, the costs associated with discrimination generally, comorbid and concurrent health issues (eg: having bipolar disorder makes taking care of yourself as a diabetic additionally challenging for a wide variety of reasons). In fact this subsection is intensely slim on any actual information about the cost of bipolar disorder (even if it were to serve as merely an introduction to the topic). Lastly, the immediately following subsection is Advocacy...surely even were this Cost-first ordering maintained (inadvisable) it is intellectually dishonest to not discuss the issues which lead to the need for advocacy, many of which have to do with...cost, and cost as a reflection on the general treatment of bipolar and disabled people in society and culture. This subsection should be moved to the bottom of the section of society and culture and marked as biased, under-researched and incomplete, or removed for revision and expansion.
In summary, the presentation of disabled people primarily as a burden and secondarily as people within society via the organization of the Society and Culture section is discriminatory in its framing. The subsection regarding the cost of bipolar disorder within society itself is grossly underdeveloped, biased and promotes discriminatory thinking towards disabled people. The section should be moved to the bottom of the section and marked as biased, marked as incomplete/lacking research & information, or removed altogether.
PS: At this moment in time this is the maximum amount of time I can put into this issue, but biased information should never be presented without at least comment. I / OG poster will not be able to effect these changes immediately. 47.184.125.109 (talk) 12:26, 3 May 2023 (UTC)
In the “Society and culture” section the bipolar 1 disorder costs is not backed up by the source (148). Cloutier et al. 2018 calculates the “total economic burden” of bipolar one rather than what the US 'spends', distinguishing between direct and indirect healthcare costs. The US only spent $46.9 billion on direct healthcare costs in 2015 not $202.1 billion.
There is a similar issue with the section on the United Kingdom – source 186 - McCrone et al. 2008 records the total cost to the UK from bipolar as £5.2 billion in 2007 although only £1.6 billion of this is from direct healthcare costs.
The section should be updated to reflect the division between the lower direct healthcare spending and the separate estimated indirect economic cost to society. The suggested changes are below.
The United States spent $46.9 billion on healthcare costs for bipolar 1 disorder (excluding subtypes) with a further estimated economic loss of $155.2 billion from lowered productivity and related substance use disorders in 2015.[148] One analysis estimated that the United Kingdom spent £1.6 billion on direct healthcare for bipolar disorder in 2007 with a further £3.6 billion loss from lowered productivity.[186] 131.111.185.76 (talk) 22:39, 26 June 2023 (UTC)
Studies have shown that individuals with bipolar disorder are overrepresented in creative fields, such as art, music, and writing. Additionally, many famous and highly creative individuals throughout history have been diagnosed with or suspected to have had bipolar disorder. Christmasmudkip1 (talk) 18:15, 6 January 2024 (UTC)
Not done: Please provide a clear rationale as to why you would like these changes made as well as reliable sources that corroborate your reasons. DiscantX 01:44, 23 February 2019 (UTC)
Already done NiciVampireHeart 09:22, 20 March 2019 (UTC)
Done Agreed-this was a bit too technical as it was previously written. I have adjusted it. TylerDurden8823 (talk) 05:42, 3 March 2020 (UTC)
A discussion is taking place to address the redirect Souutsubyou. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 March 9#Souutsubyou until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Hog Farm Talk 06:27, 9 March 2021 (UTC)
Partly done: Comorbidity "is the presence of one or more additional conditions often co-occurring with a primary condition." therefore the vocabulary seems appropriate. I've corrected the sentence though. RandomCanadian (talk / contribs) 18:56, 27 March 2021 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 26 April 2019. Further details are available on the course page. Peer reviewers: Tmatkins19, Mojoad33.
Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Callmemirela 🍁 12:59, 3 May 2023 (UTC)
![[2]](https://commons.wikimedia.org/wiki/File:Bipolar2_entwurf.png){kind=link}
![[3]](https://commons.wikimedia.org/wiki/File:Bipolar1_entwurf.png){kind=link}
![[4]](https://commons.wikimedia.org/wiki/File:Fpsyt-05-00098-g002.jpg){kind=link}
