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This paper provides a comprehensive overview of the available research and current debate on the disorder, including its diagnostic criteria, clinical presentations, comorbidities, epidemiology, risk factors, and treatment strategies. Patients with BD\u2010II often present with recurrent depressive episodes, which outnumber hypomanic episodes by a ratio of 39:1. The condition is therefore often misdiagnosed as major depressive disorder and treated with antidepressant monotherapy, which may worsen its prognosis. The recognition of BD\u2010II is further complicated by the overlap of its symptoms with other disorders, in particular borderline personality disorder. Although BD\u2010II is often perceived as a less severe form of bipolar disorder, evidence suggests significant functional and cognitive impairment, accompanied by an elevated risk of suicidal behavior, including a rate of completed suicide at least equivalent to that observed in bipolar I disorder (BD\u2010I). Psychiatric comorbidities, in particular anxiety and substance use disorders, are common. The disorder is associated with a high prevalence of numerous physical comorbidities, with a particularly high risk of comorbid cardiovascular diseases. Various genetic and environmental risk factors have been identified. Inflammation, circadian rhythm dysregulation and mitochondrial dysfunction are being studied as potential pathophysiological mechanisms. Current treatment guidelines, often extrapolated from BD\u2010I and depression research, may not fully address the unique aspects of BD\u2010II. Nevertheless, substantial evidence supports the value of some pharmacological treatments \u2013 primarily mood stabilizers and atypical antipsychotics \u2013 augmented by psychoeducation, cognitive behavioral or interpersonal and social rhythm therapy, and lifestyle interventions. Further research on BD\u2010II should be a priority, in order to refine diagnostic criteria, identify potentially modifiable risk factors, and develop targeted interventions.<\/jats:p>","DOI":"10.1002\/wps.21300","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T07:00:38Z","timestamp":1747292438000},"page":"175-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Bipolar II disorder: a state\u2010of\u2010the\u2010art review"],"prefix":"10.1002","volume":"24","author":[{"given":"Michael","family":"Berk","sequence":"first","affiliation":[{"name":"Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Barwon Health  Geelong VIC Australia"},{"name":"Mental Health, Drugs and Alcohol Service Barwon Health  Geelong VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asier","family":"Corrales","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Navarra University Hospital  Pamplona Spain"},{"name":"Mental Health Department Navarra Health System \u2010 Osasunbidea  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roth","family":"Trisno","sequence":"additional","affiliation":[{"name":"Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Barwon Health  Geelong VIC Australia"},{"name":"Mental Health, Drugs and Alcohol Service Barwon Health  Geelong VIC Australia"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetal","family":"Dodd","sequence":"additional","affiliation":[{"name":"Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Barwon Health  Geelong VIC Australia"},{"name":"Mental Health, Drugs and Alcohol Service Barwon Health  Geelong VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi N.","family":"Yatham","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Vieta","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience University of Barcelona, Hospital Clinic, IDIBAPS, CIBERSAM  Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger S.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Toronto  Toronto ON Canada"},{"name":"Department of Pharmacology University of\u00a0Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Suppes","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System  Palo Alto CA USA"},{"name":"Department of Psychiatry and Behavioral Sciences, School of Medicine Stanford University  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Agustini","sequence":"additional","affiliation":[{"name":"Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Barwon Health  Geelong VIC Australia"},{"name":"Mental Health, Drugs and Alcohol Service Barwon Health  Geelong VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/09540260500080534","article-title":"Kraepelin and manic\u2010depressive insanity: an historical perspective","volume":"17","author":"Mondimore FM","year":"2005","journal-title":"Int Rev Psychiatry"},{"key":"e_1_2_15_3_1","volume-title":"Diagnostic and statistical manual for mental disorders","author":"American Psychiatric Association","year":"1980"},{"key":"e_1_2_15_4_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3390\/bs6030014","article-title":"Historical underpinnings of bipolar disorder diagnostic criteria","volume":"6","author":"Mason B","year":"2016","journal-title":"Behav Sci"},{"key":"e_1_2_15_5_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_15_6_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40345-019-0175-7","article-title":"The existential crisis of bipolar II disorder","volume":"8","author":"Gitlin M","year":"2020","journal-title":"Int J Bipolar Disord"},{"key":"e_1_2_15_7_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0004867416641541","article-title":"Why the hype about subtype? 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