title: Early intervention in bipolar disorders: opportunities and pitfalls.
abstract: The early phases of bipolar disorders are difficult to diagnose and have specific treatment issues. The initial polarity of the illness is more commonly depressive, yet in counterpoint, mania is required for diagnosis; consequently, there is often a substantial delay in the initiation of appropriate therapy. There is good evidence that lithium in particular is most effective early in the illness course, and that its efficacy declines after multiple episodes. The notion of neuroprotection reflects this, and furthermore suggests that appropriate therapy may prevent the neurostructural and neurocognitive changes seen in the disorder. Inappropriate therapy may worsen the course of the illness. Patients with a first episode have specific psychosocial needs, and adherence to medication is relatively poor. There is a need for early identification, and to develop treatments and services applicable to the specific needs of this population.
authors: Barwon Health, University of Melbourne, Geelong, VIC, Australia. mikebe@barwonhealth.org.au
authors: Michael
authors: M
authors: Berk
authors: Karen
authors: K
authors: Hallam
authors: Nellie
authors: N
authors: Lucas
authors: Melissa
authors: M
authors: Hasty
authors: Craig A
authors: CA
authors: McNeil
authors: Philippe
authors: P
authors: Conus
authors: Linda
authors: L
authors: Kader
authors: Patrick D
authors: PD
authors: McGorry
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000628:therapy*; D042241:Early Diagnosis; D006801:Humans; D007398:Interpersonal Relations; D018020:Lithium Compounds / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000627:therapeutic use
chemical_list: D018692:Antimanic Agents; D018020:Lithium Compounds; D018696:Neuroprotective Agents