title: Recognition of bipolar disorder type I before the first manic episode: challenges and developments.
abstract: Bipolar disorder (BD) usually follows a neurobiological progression pathway, but a relatively long interval between the first symptoms of the disorder and the correct diagnosis and treatment takes place in most patients. Strategies used to recognize BD at an early stage and even prior to the first manic episode could help identify the risk and modifying factors that influence the onset and course of disease, and improve outcomes. Drawing on current research results, this article presents considerations on risk factors for the development of BD, including genetic/familial risk, endophenotypes and clinical characteristics. Taken together, this article provides a framework and tools for research on the BD prodrome, as well as for the early recognition and timely treatment of patients prior to and immediately after the emergence of BD.
authors.affiliation: Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil. marianenoto@hotmail.com
authors.forename: Mariane Nunes
authors.initials: MN
authors.lastname: Noto
authors.forename: Cristiano
authors.initials: C
authors.lastname: de Souza Noto
authors.forename: Danilo Rocha
authors.initials: DR
authors.lastname: de Jesus
authors.forename: André
authors.initials: A
authors.lastname: Zugman
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Mansur
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Berberian
authors.forename: Emilie
authors.initials: E
authors.lastname: Leclerc
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Elisa
authors.initials: E
authors.lastname: Brietzke
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D058068:Endophenotypes; D006801:Humans; D062706:Prodromal Symptoms; D012307:Risk Factors