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Staging systems in bipolar disorder: An International Society for Bipolar Disorders Task Force Report

journal contribution
posted on 2014-11-01, 00:00 authored by F Kapczinski, P V S Magalhães, V Balanzá-Martinez, V V Dias, S Frangou, C S Gama, A Gonzalez-Pinto, I Grande, K Ha, M Kauer-Sant'Anna, M Kunz, R Kupka, M Leboyer, C Lopez-Jaramillo, R M Post, J K Rybakowski, J Scott, S Strejilevitch, M Tohen, G Vazquez, L Yatham, E Vieta, Michael BerkMichael Berk
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. Method: 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. Conclusion: 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.

History

Journal

Acta Psychiatrica Scandinavica

Volume

130

Issue

5

Pagination

354 - 363

Publisher

Wiley-Blackwell

Location

Malden, United States

ISSN

0001-690X

eISSN

1600-0447

Language

eng

Publication classification

C Journal article; C1 Refereed article in a scholarly journal

Copyright notice

2014, Wiley Blackwell