Have Your Say!

Amongst the many controversies across the full range of psychiatric disorders, mood disorders are arguably one of the most likely to cause discord. This is because all aspects of the disorders require clarification and much deeper understanding is needed throughout, from diagnosis to treatment. With respect to diagnosis for example a number of key questions that are still unanswered are whether mood disorders form a ‘true spectrum’ (an uninterrupted sweep) that extends from depression through to mania, and whether there are discrete subtypes within the spectrum that have identifiable neurobiological footprints. An even more fundamental question is whether mood itself warrants primacy when defining mood disorders. Attempts to address these questions are being facilitated with the assistance of genetics, neuroimaging, neurocognitive studies, and studies examining inflammatory and cellular markers, alongside crosssectional and longitudinal epidemiological studies. The reality is that pure forms of mood disorders seldom occur, prompting once again further inquiry into the delineation of mood disorders. These studies attempt to identify distinct entities amongst the seeming ubiquitous comorbidity of mood disorders with personality factors, anxiety symptoms and substance misuse. Uncertainty regarding diagnosis and taxonomy has meant a lack of specificity regarding treatment pathways for care, which vary considerably according to geography and availability of services resulting in very different emphasis being placed on psychological versus pharmacological and physical treatments. Within pharmacotherapy for example, few steps are completely agreed upon and even fewer treatments are deemed necessary or essential. Hence, not surprisingly, the outcomes of treatments are also difficult to anticipate, and response, remission and recovery are not guaranteed with many of these improvements often seeming to be a chance occurrence. Research into the causes of mood disorders, the specific aetiopathogenesis of depression and mania, the precipitants of episodes and the factors that exacerbate onset and progression are the focus of widespread research. In recent years these efforts have produced a steady stream of new insights that are building to a better and deeper understanding of the origins of mood disorders, but translation of this knowledge into a better taxonomy and treatment paradigms remains a significant challenge. With so many facets to mood disorders, almost all of which remain disputed and with so much at stake clinically, it is imperative that those in the field actively engage in discussion and debate, and make it part of their purpose to challenge the zeitgeist and critique current concepts and ideas with a view to generating new models and new understanding. Concepts have to be formulated, models have to be tested and findings from experiments have to be applied clinically. These and many other steps in the process of translating from hypothesis to practice are essential components of our role as clinicians and academics. This is a key goal for Bipolar Disorders, which now encompasses both depressive and bipolar disorders. As the journal sets course for this new direction and aims to embrace novel ideas, this is the time for researchers and clinicians to add their voice. The journal is creating new sections that will allow viewpoints and perspectives to be captured in the form of debates, comments and erudite opinions (see specifications published online). The journal will maintain its high scientific calibre and thrust on advancing all manner of science from benchtop to bedside, addressing all the important questions in mood disorders but, at the same time, it will endeavour to provide a forum for sophisticated and intelligent debate on the key challenges that face the field. So step up to the mike and have your say!