Diagnosis, treatment, and recovery maintenance in bipolar depression.

Misdiagnosis of bipolar disorder and inappropriate pharmacotherapeutic treatment is common. Clinicians should screen for manic/hypomanic symptoms during depressive episodes to differentiate bipolar depression from other depressive disorders. Depression is the dominant pole of bipolar disorder, and effective maintenance therapy must prevent depressive episode recurrence. Few pharmacologic treatments have evidence supporting both short- and long-term efficacy for bipolar depression. Clinicians must consider the existing evidence on the long-term efficacy of various pharmacologic and psychosocial interventions for preventing and treating bipolar mood episodes.