Staging bipolar disorder.
The purpose of this study was to analyze the evidence supporting a staging model for bipolar disorder. The authors conducted an extensive Medline and Pubmed search of the published literature using a variety of search terms (staging, bipolar disorder, early intervention) to find relevant articles, which were reviewed in detail. Only recently specific proposals have been made to apply clinical staging to bipolar disorder. The staging model in bipolar disorder suggests a progression from prodromal (at-risk) to more severe and refractory presentations (Stage IV). A staging model implies a longitudinal appraisal of different aspects: clinical variables, such as number of episodes and subsyndromal symptoms, functional and cognitive impairment, comorbidity, biomarkers, and neuroanatomical changes. Staging models are based on the fact that response to treatment is generally better when it is introduced early in the course of the illness. It assumes that earlier stages have better prognosis and require simpler therapeutic regimens. Staging may assist in bipolar disorder treatment planning and prognosis, and emphasize the importance of early intervention. Further research is required in this exciting and novel area.
Vieta
Eduard
E
Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036 Barcelona, Spain. evieta@clinic.ub.es
Reinares
M
M
Rosa
A R
AR
D000818:Animals; D015415:Biomarkers; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans
D015415:Biomarkers
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