The prevalence of bipolar affective disorder is 3% in the general population, with a first occurrence around the age of 20-30. The first symptoms are usually rather mild, thus it is difficult to reach a decision about the diagnosis within the first years. In the past years bipolar affective disorder received increased attention because of the relatively high lifetime prevalence. Nowadays experts in the field try to reach a consensus in understanding the earlier phases of the syndrome, as earlier therapeutic interventions tend to have a better result. General developmental psychopathological factors, and gene-environment interactions or evolutionary theories can greatly contribute to early recognition and understanding of the syndrome. The main aim of our article is to explore the possible developmental psychopathological background of bipolar affective disorder through overview of the literature on general developmental psychopathology factors, gene-environment interaction, and the evolutionary approach, which can contribute to more effective methods of treatment.