title: Clinical and demographic features associated with the detection of early warning signs in bipolar disorder.
abstract: OBJECTIVE
  The detection of early warning signs is a major component of many psychological interventions for assisting in the management of bipolar disorder. The aim of this study was to assess whether the ability to detect early warning signs was associated with clinical and demographic characteristics in a bipolar disorder clinic sample.
  
  
  METHODS
  Two-hundred-and-one participants with DSM-IV bipolar I or II disorder aged over 18 years of age were recruited through a specialized bipolar disorder clinic. Participants were administered a structured interview by psychiatrists asking participants about any early warning signs, and features of the phenomenology, course and treatment of bipolar disorder.
  
  
  RESULTS
  Participants were significantly more likely to recognise both hypo/manic and depressive early warning signs rather than only one type of mood episode. The ability to detect signs of both hypo/mania and depression was greater in younger participants. The ability to detect signs of depression was associated with more prior depressive episodes and a lesser likelihood of prior hospitalisations whilst a history of mixed mood was associated with a greater likelihood of detecting depressive symptoms. The ability to recognise signs of hypo/mania was greater in those reporting a history of visual hallucinations (during depressive and/or manic episodes).
  
  
  CONCLUSIONS
  Cross-sectional design and previous experience with psychotherapy was not assessed.
  
  
  CONCLUSIONS
  These findings provide useful clinical data pertinent to psychological interventions for bipolar disorder. Longitudinal studies are needed to further examine how the ability to recognise early warning signs may be associated with longer term outcome.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia. t.perich@unsw.edu.au
authors.forename: Tania
authors.initials: T
authors.lastname: Perich
authors.forename: Philip B
authors.initials: PB
authors.lastname: Mitchell
authors.forename: Colleen
authors.initials: C
authors.lastname: Loo
authors.forename: Dusan
authors.initials: D
authors.lastname: Hadzi-Pavlovic
authors.forename: Gloria
authors.initials: G
authors.lastname: Roberts
authors.forename: Andrew
authors.initials: A
authors.lastname: Frankland
authors.forename: Phoebe
authors.initials: P
authors.lastname: Lau
authors.forename: Adam
authors.initials: A
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D003710:Demography; D003863:Depression; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult