Better care and more research into treatments for people experiencing a first manic episode are urgently needed, according to researchers. The study describes patchy and inconsistent care, widespread failure to detect bipolar disorder early enough, and a lack of guidance on how to treat people experiencing mania for the first time.

The study, published today in The Lancet Psychiatry by a team of international experts, describes patchy and inconsistent care, widespread failure to detect bipolar disorder early enough, and a lack of guidance on how to treat people experiencing mania for the first time.

The researchers reviewed current evidence to illustrate the prevalence and health burden of bipolar disorder, the typical progression of illness, evidence for a range of interventions and the content of international guidelines.

Calling for clearer treatment guidelines and targeted care within existing services, they describe how people experiencing first episode mania have been overlooked by health services, despite evidence for effective treatments. They say that care is inconsistent and that few trials have examined interventions specifically for people who have had a first manic episode.

People with bipolar disorder are 50 times more likely to self-harm compared to the general population, and at least 12 times more likely to take their own lives (higher than the rate for people with schizophrenia). The World Health Organization’s Global Burden of Disease ranked bipolar disorder as the fourth leading cause of overall disease burden in people aged 10 to 24. Analyses suggest that almost 50 per cent of people present with symptoms before the age of 21, and a recent review of 27 studies suggested an average delay of almost six years between first symptoms of bipolar disorder and targeted treatment.

This new study highlights a lack of high-quality evidence for interventions in first episode mania, as well as gaps in guidelines on how to treat people experiencing mania for the first time.

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Materials provided by King’s College London — Institute of Psychiatry. Note: Content may be edited for style and length.