Bipolar Disorder: not only in the Brain - immunological aspects

The main objective of this thesis was to obtain more insight in the role of the immune system in the pathogenesis of bipolar disorder by investigating various aberrancies in the immune system of patients with bipolar disorder. In Chapter 1 some general concepts, important for the perception of this thesis, are presented. Background information on bipolar disorder, the immune system, and the hypothalamus pituitary adrenal axis is given. Bipolar disorder is a severe and chronic mood disorder with a prevalence ranging from .3-3.7% (generally 1.3-1.6%) and a complex etiology. There is increasing evidence that the immune system plays a significant role in the pathophysiology of mood disorders, but research in this field particularly focussed on major depression. In this chapter an overview of earlier published research on immune abnormalities in mood disorders, especially bipolar disorder, is given. It is clear that not all immune findings point in the same direction, mainly due to diverse methodological approaches. Consequently, much of the involved mechanisms need further clarification. Also the role of lithium is mentioned, a potent mood stabilizer with immune modulating capacity.

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