title: Instruments that prospectively predict bipolar disorder - A systematic review.
abstract: BACKGROUND
  Identification of earlier stages of Bipolar Disorder (BD), even prior to the first manic episode, may help develop interventions to prevent or delay the onset of BD. However, reliable and valid instruments are necessary to ascertain such earlier stages of BD. The aim of the current review was to identify instruments that had predictive validity and utility for BD for use in early intervention (EI) settings for the prevention of BD.
  
  
  METHODS
  We undertook a systematic examination of studies that examined participants without BD I or II at baseline and prospectively explored the predictive abilities of instruments for BD onset over a period of 6 months or more. The instruments and the studies were rated with respect to their relative validity and utility predicting onset of BD for prevention or early intervention. Odds ratios and area under the curve (AUC) values were derived when not reported.
  
  
  RESULTS
  Six studies were included, identifying five instruments that examined sub-threshold symptoms, family history, temperament and behavioral regulation. Though none of the identified instruments had been examined in high-quality replicated studies for predicting BD, two instruments, namely the Child Behavioral Checklist - Pediatric BD phenotype (CBCL-PBD) and the General Behavioral Inventory - Revised (GBI-R), had greater levels of validity and utility.
  
  
  CONCLUSIONS
  Non-inclusion of studies and instruments that incidentally identified BD on follow-up limited the breadth of the review.
  
  
  CONCLUSIONS
  Instruments that test domains such as subthreshold symptoms, behavioral regulation, family history, and temperament hold promise in predicting BD onset.
authors.affiliation: Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia. Electronic address: aswinr@unimelb.edu.au.
authors.forename: Aswin
authors.initials: A
authors.lastname: Ratheesh
authors.affiliation: Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia; Impact Strategic Research Centre, Deakin University, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.affiliation: Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Davey
authors.affiliation: Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Cotton
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis*; D006801:Humans; D011237:Predictive Value of Tests; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors
keywords: Bipolar; Depression; Early intervention; Instruments; Mania; Prediction