Clinical Staging in Bipolar Disorder

Rosa, Adriane Ribeiro; Magalhães, Pedro Vieira da Silva; Czepielewski, Letícia Sanguinetti; Sulzbach, Miréia Viana; Goi, Pedro Domingues; Vieta, Eduard; Gama, Clarissa Severino; Kapczinski, Flávio

doi:10.4088/jcp.13m08625

Cited by 128 publications

(34 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Probably severe somatic comorbidity is present also, but this remains to be shown. These are in accord with research data which support the validity of the early vs. late stages in terms of differences in functioning and disability Rosa et al 2012Rosa et al , 2014Scott et al 2013 ;Hamilton et al 2011 ).…”

Section: Clinical Determinants Of Bd Stagingsupporting

confidence: 88%

Staging of Bipolar Disorder

Fountoulakis

2014

Bipolar Disorder

View full text Add to dashboard Cite

Section: Clinical Determinants Of Bd Stagingsupporting

confidence: 88%

Staging of Bipolar Disorder

Fountoulakis

2014

Bipolar Disorder

View full text Add to dashboard Cite

“…These findings are also concordant with those of Reinares, who showed that early stage individuals were more likely to respond to psychoeducation than late stage individuals, manifested by a longer time to recurrence (Colom, 2010). It is possible that this is related to the cognitive progression that is seen in the disorder, intact cognition being necessary for cognitively based approaches (Rosa et al, 2014). Alternative to progressive staging models that tend to assume a unitary progression, it could also be the case that our findings represent two distinct forms of bipolar illness with different genetic underpinnings that present as generally mild or more severe phenotypes.…”

Section: Discussionmentioning

confidence: 99%

A cluster analytic approach to identifying predictors and moderators of psychosocial treatment for bipolar depression: Results from STEP-BD

Deckersbach

Peters

Sylvia

et al. 2016

Journal of Affective Disorders

View full text Add to dashboard Cite

Background We sought to address how predictors and moderators of psychotherapy for bipolar depression – identified individually in prior analyses – can inform the development of a metric for prospectively classifying treatment outcome in intensive psychotherapy (IP) versus collaborative care (CC) adjunctive to pharmacotherapy in the Systematic Treatment Enhancement Program (STEP-BD) study. Methods We conducted post-hoc analyses on 135 STEP-BD participants using cluster analysis to identify subsets of participants with similar clinical profiles and investigated this combined metric as a moderator and predictor of response to IP. We used agglomerative hierarchical cluster analyses and k-means clustering to determine the content of the clinical profiles. Logistic regression and Cox proportional hazard models were used to evaluate whether the resulting clusters predicted or moderated likelihood of recovery or time until recovery. Results The cluster analysis yielded a two-cluster solution: 1) “less-recurrent/severe” and 2) “chronic/recurrent.” Rates of recovery in IP were similar for less-recurrent/severe and chronic/recurrent participants. Less-recurrent/severe patients were more likely than chronic/recurrent patients to achieve recovery in CC (p = .040, OR = 4.56). IP yielded a faster recovery for chronic/recurrent participants, whereas CC led to recovery sooner in the less-recurrent/severe cluster (p = .034, OR = 2.62). Limitations Cluster analyses require list-wise deletion of cases with missing data so we were unable to conduct analyses on all STEP-BD participants. Conclusions A well-powered, parametric approach can distinguish patients based on illness history and provide clinicians with symptom profiles of patients that confer differential prognosis in CC vs. IP.

show abstract

“…Leopold et al found 16% of youths to be at risk of BD in a referred sample [122]. according to the levels of the staging models [126]. They found a linear association between the severity of the functional impairment and the clinical stages.…”

Section: Validity Of Staging Modelsmentioning

confidence: 99%

Early interventions for youths at high risk for bipolar disorder: a developmental approach

Benarous

Consoli

Milhiet

et al. 2015

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.

show abstract

Clinical Staging in Bipolar Disorder

Cited by 128 publications

References 0 publications

Staging of Bipolar Disorder

Staging of Bipolar Disorder

A cluster analytic approach to identifying predictors and moderators of psychosocial treatment for bipolar depression: Results from STEP-BD

Early interventions for youths at high risk for bipolar disorder: a developmental approach

Contact Info

Product

Resources

About