사도세자의 죽음에 대하여 그가 당쟁의 희생양이었다는견해와 그의 정신병적 증상이 원인이었다는 견해가 있는데,이에 대해서는 여전히 논란이 있다. 본 연구에서는 사도세자에 관한 문헌을 검토하여 사도세자의 정신증상 여부에 대하여 정신의학적으로 고찰해 보았다. 사도세자의 언행에 대해상세히 기술되어 있는 한중록을 중심으로 검토한 결과, 사도세자는 여러 차례의 우울삽화 및 조증삽화를 겪었으며, 기분삽화가 재발과 관해를 반복하는 경과를 보였던 것으로 생각된다. 그의 직계가족을 중심으로 가족들의 정신증상 유무에대하여 조사한 결과 기분장애의 가족력 또한 배제할 수 없었다. 이를 토대로 볼 때 사도세자에게 양극성 장애가 있었을가능성이 높은 것으로 생각된다.

Objectives Prince Sado was the tragic royal heir who was sealed in a rice chest and starved to death by his father, King Yeongjo. The question of whether he was a victim of party strife or his death was the result of his psychiatric disorder is still controversial. In this paper, we investigated the question of whether he had suffered from bipolar disorder by reviewing his psychiatric symptoms and family history. Methods We examined the available literature on Prince Sado and his family, particularly focusing on Hanjungnok (Memoirs of Lady Hyegyeong), written by Prince Sado’s wife. Results Review of the literature showed that Prince Sado suffered from psychiatric symptoms, including depressed mood, anxiety, suicidal behavior, aggressive behavior, and persecutory delusion from the age of 13 to 27. Many of his symptoms match the Diagnostic and Statistical Manual of Mental Disorders’ criteria for depressive and manic episodes and it is highly suspected that he had bipolar disorder. He also showed clothing phobia, which can be regarded as an obsessive compulsive symptom. Some of his relatives, King Gyeongjong and Sanggyegun, might have suffered from depressive disorder. Conclusion The characteristics of his symptoms suggest that Prince Sado might have had bipolar disorder. His mental disorder might explain in part the cause of his death.