Affective disorder (AD) is a common complex disease, which mainly includes severe mental illness (SMI), major depression (MDD), and bipolar affective disorder (BD) as the core diagnosis and extends to other diseases. AD is one of the most frequently associated mental diseases with death caused by physical health. Affective disorder is a significant challenge to global health in the 21st century. In the United States alone, nearly 14 million patients suffer from affective disorder, accounting for 4.4% of the adult population (Johnson and Johnson, 2014). The social and economic costs, disability rates, increased mortality, and personal pain to patients and their relatives caused by the affective disorder has caused a considerable burden worldwide (Sanacora et al., 2008). Some researchers pointed out that cognitive impairment is an integral part of the symptoms of affective diseases. While most affective disorders also include one or more other symptoms, such as a series of psychological disorders, thinking and behavior disorders from extreme excitement or mania to severe depression, which may be manifested as insanity and hallucinations in extreme cases. Therefore, as a particularly vulnerable group, patients with affective disorders are prone to problems in the interaction between treatment and medical services; for example, their sense of well-being deteriorates due to difficulties in adapting to the clinical environment, which leads to an upward trend in post-traumatic stress symptoms among patients with mental diseases (Fleischmann et al., 2021). Many mental health researchers emphasized the necessity of increasing treatment support for this specific population (Fleischmann et al., 2021).
Psychopharmacology is usually the routine treatment method for affective disorders. However, in routine treatment, many patients report insufficient symptom resolution, and the recurrence rate is still high (Maroney, 2020). Facts have proved that severe affective disorders often have a high complication rate with physical and other mental diseases. In addition to the significant risk of self-caused death, it also marks a high mortality rate (Paykel et al., 1995). Unlike other medical branches where clinicians can rely on objective measures (blood examination, imaging methods, etc.), in psychiatry, diagnosis is mediated by subjectivism, affecting the reliability of the evaluation methods used. Therefore, the frequent changes in psychotropic drugs lead to an increased risk of drug-resistant diseases and relapses (Keks et al., 2019). The inappropriate or delayed intervention is caused by common misdiagnosis, lack of or poor treatment of groups with affective disorders, limited medical and psychological treatment resources, and other extra pressures caused by the COVID-19 pandemic (Gautam et al., 2020; Liebrenz et al., 2020). Poor response to biological and psychological intervention (Angst et al., 2011). According to the analysis of data from the United States by P.B. Mitchell et al., more than three-quarters of patients with bipolar disorder were misdiagnosed at the first visit. The most common misdiagnoses are monophasic depression (60% of cases) and anxiety disorder (26%) (Mitchell et al., 2004). Despite the release of diagnostic guidelines (Moller et al., 2010), there are still many missed diagnoses or misdiagnoses. In addition, in March 2020, the coronavirus disease (COVID-19) will reach a global pandemic (Fleischmann et al., 2021).
In order to prevent the spread of the virus, many countries worldwide have implemented blockade measures, including keeping physical distance, closing public facilities, and restricting travel (Fleischmann et al., 2021). The mental status of both healthy and mentally ill people is affected by the COVID-19 pandemic. Studies have shown that the COVID-19 pandemic has led to problems such as blocked social and economic growth, rising unemployment rate, etc., which have increased the fear of an uncertain future for individuals, aggravated their mental distress, and caused a series of mental health problems (Fleischmann et al., 2021). According to the investigation of Skoda EM, the symptoms of different mental disorders are significantly higher after the epidemic. Anxiety (Fleischmann et al., 2021), pain (Fleischmann et al., 2021), fear of disease (Fleischmann et al., 2021), loneliness (Fleischmann et al., 2021), post-traumatic stress symptoms, and depression (Fleischmann et al., 2021). Among them, the prevalence of anxiety and suicide tendency has increased significantly, especially the prevalence of depression, which indicates the need for more research in this field (Fleischmann et al., 2021).
Since the 21st century, many academic papers on treating affective disorders have been published. However, few studies have systematically reviewed and investigated this field, so it is not easy to effectively evaluate its main progress and insights.
Bibliometric citation analysis is a widely used new data-driven method for drawing literature maps (Chen et al., 2012). It is widely used in research trend detection, institutional cooperation analysis, national cooperation analysis, discipline field changes, etc. (Carve et al., 2021). It can conduct quantitative analysis of patterns in scientific literature, review a research field and analyze its emerging trends. It has a knowledge-oriented quantitative function (Tan et al., 2021; Zhou et al., 2018). The use of bibliometrics is gradually expanding to all disciplines. Scientific metrological reviews are more systematic, comprehensive, and objective than traditional reviews. This paper uses the Bibliometrix R Package (Abdpour and Santos, 2021), CiteSpace (Chen et al., 2009), and VOS viewer (van Eck and Waltman, 2010) software to evaluate the collected data on the treatment of affective disorders, which provides an overall understanding of this evolution in the field of affective disorder treatment. It brings unique insights into its prospects and opportunities, thus providing clues for discovering current research hotspots and knowledge gaps. Most importantly, through evolutionary analysis and hot spot identification, a clear and accurate overall perspective can be provided for the future development of the field of affective disorder therapy.