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Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251-269. doi: 10.1177/2045125318769235. eCollection 2018 Sep.

Epidemiology and risk factors for bipolar disorder.

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Unit of Mental Health and Wellbeing, Division of Health Sciences, University of Warwick, Coventry, CV4 7AL, UK.
Division of Health Sciences, University of Warwick, Coventry, UK.


Bipolar disorder is a multifactorial illness with uncertain aetiology. Knowledge of potential risk factors enables clinicians to identify patients who are more likely to develop bipolar disorder, which directs further investigation, follow up and caution when prescribing. Ideally, identifying directly causative factors for bipolar disorder would enable intervention on an individual or population level to prevent the development of the illness, and improve outcomes through earlier treatment. This article reviews the epidemiology of bipolar disorder, along with putative demographic, genetic and environmental risk factors, while assessing the strength of these associations and to what extent they might be said to be 'causative'. While numerous genetic and environmental risk factors have been identified, the attributable risk of individual factors is often small, and most are not specific to bipolar disorder but are associated with several mental illnesses. Therefore, while some genetic and environmental factors have strong evidence supporting their association with bipolar disorder, fewer have sufficient evidence to establish causality. There is increasing interest in the role of specific gene-environment interactions, as well as the mechanisms by which risk factors interact to lead to bipolar disorder.


bipolar disorder; epidemiology; risk factors

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Conflict of interest statement: The authors declare that there is no conflict of interest.

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