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On average, participants had had their first depressive or manic episode when they were 17, and many had other mental health conditions.The seven phenoclasses, as the U-M team has dubbed them, include standard measures doctors already use to diagnose and track the progress of bipolar disorder.

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Even though bipolar disorder tends to run in families, the long-term study has revealed no one gene that ‘carries the day’ to explain it, says Mc Innis, who is the Woodworth Professor of Bipolar Disorder and Depression in the U-M Medical School’s Department of Psychiatry.

“If there was a gene with a strong effect like what we see in breast cancer, for instance, we would have found it,” he explains.

“We hope this new framework will provide a new approach to understand this disorder, and other complex diseases, by developing models that can guide a management strategy for clinicians and patients, and give researchers consistent variables to measure and assess.”He adds, “Bipolar disorder has a lot to teach humankind about other illnesses, because it covers the breadths of human mood, emotion and behavior like no other condition.

• People with bipolar disorder who have a strong neurotic tendency in their personalities are more likely to have severe illness, especially among men.

• A range of cognitive abilities – including memory, executive functioning and motor skills – were poorer in participants with bipolar than those without, in general.

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