Inflammatory Monocytes in Bipolar Disorder and Related Endocrine Autoimmune Diseases

Bipolar disorder (also called manic-depressive illness) is one of the major mood disorders. The term manic-depressive illness was introduced by Emil Kraepelin (1856-1926) in the late nineteenth century.1 It is in most patients a chronic illness with recurrent manic and depressive episodes, usually alternated with periods with normal mood between the episodes. A manic episode is characterised by an elevated, expansive or irritable mood which can be accompanied by a high self-esteem, decreased need of sleep, flight of ideas or racing thoughts, increased speech, distractibility, psychomotor agitation and excessive involvement in activities with painful consequences. A hypomanic episode meets the criteria for mania but is not associated with social or occupational impairment as is the case with a manic episode. A patient with a depressed episode has a depressed mood together with the possible following symptoms: sleep disturbances, psychomotor retardation or agitation, fatigue, feelings of worthlessness or guilt, impaired thinking or concentration, change of appetite or weight and suicidal thoughts.2, 3 With its manic episodes bipolar disorder differs from (unipolar) depression, which is characterized by one or more depressive episodes, but never a manic (or hypomanic) episode.

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