title: Characteristics, symptomatology and naturalistic treatment in individuals at-risk for bipolar disorders: baseline results in the first 180 help-seeking individuals assessed at the Dresden high-risk project.
abstract: BACKGROUND
  Considering results from the early recognition and intervention in psychosis, identification and treatment of individuals with at-risk states for the development of bipolar disorders (BD) could improve the course and severity of illness and prevent long-term consequences. Different approaches to define risk factors and groups have recently been published, data on treatment options are still missing.
  
  
  METHODS
  Help-seeking persons at the early recognition center in Dresden, Germany, were assessed with a standardized diagnostic procedure including following risk factors for BD: familial risk, increasing mood swings, subsyndromal (hypo)manic symptoms, specific sleep and circadian rhythm disturbances, anxiety/fearfulness, affective disorder, decreased psychosocial functioning, increasing periodic substance use, and attention-deficit/hyperactivity disorder. Based on symptomatology and current and/or life-time psychiatric diagnosis, subjects with an at-risk state were offered individual treatment options.
  
  
  RESULTS
  Out of 180 referred and screened persons, 29 (16%) met criteria for at-risk state for BD. Altogether, 27 (93%) at-risk individuals fulfilled criteria for a current and/or life-time mental illness other than BD; 14 (48%) had received pharmacological and/or psychotherapeutic treatment in the past. Treatments recommended included psychoeducation (100%), psychotherapy alone (62%), pharmacotherapy alone (17%), and psychotherapy+pharmacotherapy (14%).
  
  
  CONCLUSIONS
  To identify at-risk states for BD, a multifactorial approach including all known risk markers should be used. As most at-risk patients meet criteria for other mental disorders, the short- and long-term impact of different treatment strategies on symptomatic, functional and diagnostic outcomes requires detailed investigation.
  
  
  CONCLUSIONS
  Small sample size of at-risk individuals, lack of sufficient prospective data and control groups.
authors.affiliation: Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Germany. Electronic address: Karolina.leopold@uniklinikum-dresden.de.
authors.forename: Karolina
authors.initials: K
authors.lastname: Leopold
authors.forename: Susann
authors.initials: S
authors.lastname: Ratzer
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Maren
authors.initials: M
authors.lastname: Rottmann-Wolf
authors.forename: Steffi
authors.initials: S
authors.lastname: Pfeiffer
authors.forename: Philipp
authors.initials: P
authors.lastname: Ritter
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Andrea
authors.initials: A
authors.lastname: Pfennig
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Bipolar disorder; Early recognition; Intervention; Prodrome; Staging