Department of Psychiatry, University of California, San Diego, La Jolla, California 92093, USA; email:
Annu Rev Clin Psychol. 2020 May 7;16:239-264. doi: 10.1146/annurev-clinpsy-050718-095449. Epub 2020 Feb 10.
Bipolar disorder is a lifelong mood disorder characterized by extreme mood swings between mania and depression. Despite fitness costs associated with increased mortality and significant impairment, bipolar disorder has persisted in the population with a high heritability and a stable prevalence. Creativity and other positive traits have repeatedly been associated with the bipolar spectrum, particularly among unaffected first-degree relatives and those with milder expressions of bipolar traits. This suggests a model in which large doses of risk variants cause illness, but mild to moderate doses confer advantages, which serve to maintain bipolar disorder in the population. Bipolar disorder may thus be better conceptualized as a dimensional trait existing at the extreme of normal population variation in positive temperament, personality, and cognitive traits, aspects of which may reflect a shared vulnerability with creativity. Investigations of this shared vulnerability may provide insight into the genetic mechanisms underlying illness and suggest novel treatments.
双相情感障碍是一种终身的情绪障碍，其特征是躁狂和抑郁之间的极端情绪波动。尽管与死亡率增加和显著损伤相关的健康成本，双相情感障碍仍在人群中持续存在，具有高遗传性和稳定的患病率。创造力和其他积极特征已反复与双相情感障碍谱相关联，特别是在未受影响的一级亲属和那些表现出较轻双相情感障碍特征的人群中。这表明了一种模型，其中大量的风险变异会导致疾病，但轻度至中度剂量会带来优势，这有助于在人群中维持双相情感障碍。因此，双相情感障碍可以更好地被理解为一种在正常人群的积极气质、个性和认知特征的极端范围内存在的维度特征，其中的某些方面可能反映了与创造力的共同脆弱性。对这种共同脆弱性的研究可能会深入了解疾病的遗传机制，并为新的治疗方法提供思路。
