Clinical staging and serum cytokines in bipolar patients during euthymia

Tatay-Manteiga, Amparo; Balanzá‐Martínez, Vicent; Bristot, Giovana; Tabarés‐Seisdedos, Rafael; Kapczinski, Flávio; Cauli, Omar

doi:10.1016/j.pnpbp.2017.04.028

Cited by 39 publications

(26 citation statements)

References 68 publications

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“…This might be due to inflammatory processes in BD, which cause neurobiological and functional impairment increasing with illness duration . Recently, Tatay‐Manteiga et al described an association between biomarkers of inflammation and poorer functional outcome of BD patients by depicting differences in inflammation markers in BD patients in different stages of the disease . On the other hand, our results could also be attributed to the continuous or prolonged use of psychopharmacological medication .…”

Section: Discussionmentioning

confidence: 63%

A step ahead: Exploring the gut microbiota in inpatients with bipolar disorder during a depressive episode

et al. 2018

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Section: Discussionmentioning

confidence: 63%

A step ahead: Exploring the gut microbiota in inpatients with bipolar disorder during a depressive episode

et al. 2018

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“…Recently, it has been reconceptualized as a changing disorder with different clinical manifestations over the course of its development from an at-risk or latent stage to a late or end-stage, thus supporting the assumption that it would benefit from a staging model 1 . Clinical manifestations consistent with staging models include cognitive deterioration and functional decline 2,3 , changes in inflammatory and neuroanatomical biomarkers [3][4][5][6][7][8][9] , less response to treatment 10 , and worse self-reported quality of life (QoL) 11 linked to disorder progression.…”

Section: Introductionmentioning

confidence: 93%

A clinical staging model for bipolar disorder: longitudinal approach

et al. 2020

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Bipolar disorder (BD) has been identified as a life-course illness with different clinical manifestations from an at-risk to a late stage, supporting the assumption that it would benefit from a staging model. In a previous study, we used a clustering approach to stratify 224 patients with a diagnosis of BD into five clusters based on clinical characteristics, functioning, cognition, general health, and health-related quality of life. This study was design to test the construct validity of our previously developed k-means clustering model and to confirm its longitudinal validity over a span of 3 years. Of the 224 patients included at baseline who were used to develop our model, 129 (57.6%) reached the 3-year follow-up. All life domains except mental health-related quality of life (QoL) showed significant worsening in stages (p < 0.001), suggesting construct validity. Furthermore, as patients progressed through stages, functional decline (p < 0.001) and more complex treatment patterns (p = 0.002) were observed. As expected, at 3 years, the majority of patients remained at the same stage (49.6%), or progressed (20.9%) or regressed (23.3%) one stage. Furthermore, 85% of patients who stayed euthymic during that period remained at the same stage or regressed to previous stages, supporting its longitudinal validity. For that reason, this study provides evidence of the construct and longitudinal validity of an empirically developed, comprehensive staging model for patients with BD. Thus, it may help clinicians and researchers to better understand the disorder and, at the same time, to design more accurate and personalized treatment plans.

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“…Alterations in neurotransmitters transporters have been suggested as markers of bipolar disorder ( 96 ), but there is no evidence on changes in neurotransmitters according to illness stage. Regarding later stages of bipolar disorder, recent studies have reported higher levels of TNF-alpha and IL-6 in late stages of bipolar disorder ( 99 , 100 ). Similarly, Soeiro-de Souza and colleagues described that patients with recurrent episodes showed increased oxidative and inflammatory markers, which were related to the number of manic episodes ( 101 ).…”

Section: From Staging To Precision Staging Modelsmentioning

confidence: 99%

Toward Precision Psychiatry in Bipolar Disorder: Staging 2.0

et al. 2018

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Personalized treatment is defined as choosing the “right treatment for the right person at the right time.” Although psychiatry has not yet reached this level of precision, we are on the way thanks to recent technological developments that may aid to detect plausible molecular and genetic markers. At the moment there are some models that are contributing to precision psychiatry through the concept of staging. While staging was initially presented as a way to categorize patients according to clinical presentation, course, and illness severity, current staging models integrate multiple levels of information that can help to define each patient's characteristics, severity, and prognosis in a more precise and individualized way. Moreover, staging might serve as the foundation to create a clinical decision-making algorithm on the basis of the patient's stage. In this review we will summarize the evolution of the bipolar disorder staging model in relation to the new discoveries on the neurobiology of bipolar disorder. Furthermore, we will discuss how the latest and future progress in psychiatry might transform current staging models into precision staging models.

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Clinical staging and serum cytokines in bipolar patients during euthymia

Cited by 39 publications

References 68 publications

A step ahead: Exploring the gut microbiota in inpatients with bipolar disorder during a depressive episode

A step ahead: Exploring the gut microbiota in inpatients with bipolar disorder during a depressive episode

A clinical staging model for bipolar disorder: longitudinal approach

Toward Precision Psychiatry in Bipolar Disorder: Staging 2.0

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