It would, for instance, be misleading and conceptually mistaken to diagnose a depressive patient with a cyclothymic temperament as being bipolar, although such a

patient, may be at greater risk than others of developing bipolar disorder over lifetime. A diagnostic application could be found in validated cutoffs on temperamental scales. Future research will need to use continuous measures for assessing temperament in population samples of different, ages. Mood lability is normal in children, but. can be pathological in adolescents. Expressions of temperament Inhibitors,research,lifescience,medical certainly change markedly over the lifespan. Age- and sex-specific norms are required. Stigma Stigmatization focuses on defined minorities; the best. weapon against it. is the demonstration that we are “all in the same boat.” Research with quantitative measures on the continuum from normal mood variations and temperament to minor and major bipolar disorders can provide that demonstration.44 We all score on instruments Inhibitors,research,lifescience,medical measuring anxiety, depression, and hypomania. The distribution is not. bimodal but. log-normal, with no clear cutoff between normal and pathological mood variations. Stigmatizing attitudes are fuelled Inhibitors,research,lifescience,medical by ignorance regarding what it.

is to be a human being. Further research in this context should not only focus on psych opathology, but, should also look at. the distinct. advantages of being hypomanic or cyclothymic, about, Inhibitors,research,lifescience,medical which there is very little representative data, although the association of CP-690550 creativity with hypomania and bipolarity is well-established on biographical grounds.45 Whybrow46 and Gartner47 have also described how American society has always been marked by the insatiable demands, high energy, and drive associated with hypomania. The onset of bipolar disorder We know regrettably little about the onset of bipolar disorder, Inhibitors,research,lifescience,medical which in one third of adult cases is retrospectively dated before the age 20. In childhood, bipolar disorder is veiy difficult to diagnose

because the full hypomanic syndrome is usually lacking. It. is certainly not possible to apply DSM-IV hypomania criteria for the early recognition of BPD. As Duffy states, most, bipolar disorders begin as depression, activated episodes are rare before 12 years of age, and the validity of the diagnosis Cilengitide of BPD in impulsive, irritable, labile, or behaviorally dysregulated children remains to be proven.48 According to a meta-analysis of the literature, the offspring of bipolar parents have a fourfold risk of developing affective disorders.49 Prospective studies of high-risk children and adolescents are therefore methodologically a. very promising approach. However, the reported early symptoms of BPD vary widely, and are subject, to very diverse interpretation.