title: Staging systems in bipolar disorder: an International Society for Bipolar Disorders Task Force Report.
abstract: OBJECTIVE
  We discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined.
  
  
  METHODS
  We reviewed the literature pertaining to bipolar disorders, focusing on the first episode onwards. We systematically searched data on staging models for bipolar disorders and allied studies that could inform the concept of staging.
  
  
  RESULTS
  We report on several dimensions that are relevant to staging concepts in bipolar disorder. We consider whether staging offers a refinement to current diagnoses by reviewing clinical studies of treatment and functioning and the potential utility of neurocognitive, neuroimaging and peripheral biomarkers.
  
  
  CONCLUSIONS
  Most studies to date indicate that globally defined late-stage patients have a worse overall prognosis and poorer response to standard treatment, consistent with patterns for end-stage medical disorders. We believe it is possible at this juncture to speak broadly of 'early'- and 'late'-stage bipolar disorder. Next steps require further collaborative efforts to consider the details of preillness onset and intermediary stages, and how many additional stages are optimal.
authors: National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors: F
authors: F
authors: Kapczinski
authors: P V S
authors: PV
authors: Magalhães
authors: V
authors: V
authors: Balanzá-Martinez
authors: V V
authors: VV
authors: Dias
authors: S
authors: S
authors: Frangou
authors: C S
authors: CS
authors: Gama
authors: A
authors: A
authors: Gonzalez-Pinto
authors: I
authors: I
authors: Grande
authors: K
authors: K
authors: Ha
authors: M
authors: M
authors: Kauer-Sant'Anna
authors: M
authors: M
authors: Kunz
authors: R
authors: R
authors: Kupka
authors: M
authors: M
authors: Leboyer
authors: C
authors: C
authors: Lopez-Jaramillo
authors: R M
authors: RM
authors: Post
authors: J K
authors: JK
authors: Rybakowski
authors: J
authors: J
authors: Scott
authors: S
authors: S
authors: Strejilevitch
authors: M
authors: M
authors: Tohen
authors: G
authors: G
authors: Vazquez
authors: L
authors: L
authors: Yatham
authors: E
authors: E
authors: Vieta
authors: M
authors: M
authors: Berk
mesh_terms: D026683:Advisory Committees; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood / Q000175:diagnosis*; D018450:Disease Progression; D006801:Humans; D012720:Severity of Illness Index; D012955:Societies, Medical
chemical_list: D015415:Biomarkers
keywords: bipolar disorder; clinical aspects; early intervention