Characterisation of the prodrome to a first episode of psychotic mania: results of a retrospective study.
BACKGROUND
Little is known about the early phases of bipolar disorders (BPAD) and most of current knowledge derives from putative "high-risk" studies conducted in populations of bipolar off-spring; such information may therefore be relevant only to a sub-group of at-risk subjects.


METHODS
Retrospective assessment of the phase preceding the emergence of mania and of premorbid characteristics of patients treated for a first episode of psychotic mania. The collected data was used mainly to generate hypotheses.


RESULTS
Before onset of a first episode of psychotic mania, patients go through a phase of change from previous mental state where they present mood symptoms, sleep disruption and general functional decline. These clinical manifestations are however likely to have low specificity. However, their occurrence in patients presenting certain risk factors or markers of vulnerability that were identified at a relatively high prevalence in our sample, may be an indicator of impending first episode mania.


CONCLUSIONS
This is a retrospective study, in a small sample of patients presenting with psychotic mania. Criteria identified need therefore to be validated in larger prospective studies.


CONCLUSIONS
Early identification of patients at risk to develop a first episode of psychotic mania is unlikely to be possible on the basis of symptoms alone. However, the occurrence of certain clinical characteristics in patients who have risk factors or markers of vulnerability to BPAD could be a sign of impending first episode mania.
Conus
Philippe
P
Traitement et Intervention Précoce dans les troubles Psychotiques (TIPP Program), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, 1008 Prilly, Switzerland. philippe.conus@chuv.ch
Ward
Janine
J
Lucas
Nellie
N
Cotton
Sue
S
Yung
Alison R
AR
Berk
Michael
M
McGorry
Patrick D
PD
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult