Setting the stage: from prodrome to treatment resistance in bipolar disorder.
Bipolar disorder is common, and both difficult to detect and diagnose. Treatment is contingent on clinical needs, which differ according to phase and stage of the illness. A staging model could allow examination of the longitudinal course of the illness and the temporal impact of interventions and events. It could allow for a structured examination of the illness, which could set the stage for algorithms that are tailored to the individuals needs. A staging model could further provide as structure for assessment, gauging treatment and outcomes. The model incorporates prodromal stages and emphasizes early detection and algorithm appropriate intervention where possible. At the other end of the spectrum, the model attempts to operationalize treatment resistance. The utility of the model will need to be validated by empirical research.
Berk
Michael
M
Barwon Health and The Geelong Clinic, Geelong, Victoria, Australia. mikebe@barwonhealth.org.au
Conus
Philippe
P
Lucas
Nellie
N
Hallam
Karen
K
Malhi
Gin S
GS
Dodd
Seetal
S
Yatham
Lakshmi N
LN
Yung
Alison
A
McGorry
Pat
P
D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D018450:Disease Progression; D004351:Drug Resistance; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use; D008960:Models, Psychological; D012008:Recurrence; D012307:Risk Factors
D000927:Anticonvulsants; D000928:Antidepressive Agents; D018020:Lithium Compounds