Staging systems in bipolar disorder: an <scp>I</scp>nternational <scp>S</scp>ociety for <scp>B</scp>ipolar <scp>D</scp>isorders <scp>T</scp>ask <scp>F</scp>orce <scp>R</scp>eport

Kapczinski, Flávio; Magalhães, Pedro Vieira da Silva; Balanzá‐Martínez, Vicent; Dias, Vasco Videira; Frangou, Sophia; Gama, Clarissa Severino; González-Pinto, Ana; Grande, Íria; Ha, Kyooseob; Kauer-Sant’Anna, Márcia; Kunz, Maurício; Kupka, Ralph; Leboyer, Marion; López‐Jaramillo, Carlos; Post, Robert M.; Rybakowski, Janusz; Scott, Jan; Strejilevitch, S.; Tohen, Mauricio; Vázquez, Gustavo; Yatham, Lakshmi N.; Vieta, Eduard; Berk, Michael

doi:10.1111/acps.12305

Cited by 186 publications

(157 citation statements)

References 82 publications

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“…Overall, the staging models describe three broad clinical stages: (I) individuals at increased risk for developing BD due to family history as well as certain subsyndromal symptoms predictive of conversion into full‐blown BD; (II) patients with fewer episodes and optimal functioning in the interepisodic periods, and (III) patients with recurrent episodes as well as decline in functioning and cognition 31. So far, the heterogeneity intrinsic to BD has prevented the clinical use of staging systems 32.…”

Section: Foundations Of Managementmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Foundations Of Managementmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…Patients were classified as being in the early or late stage of BD following the Kapczinski et al classification. 24 Healthy volunteers (n=34) were divided into two ageand sex-matched groups to control for age differences in the early-and late-stage experimental groups (early and late groups, age [range] = 32 and 36 years, respectively). All volunteers were recruited at HCPA.…”

Section: Subjectsmentioning

confidence: 99%

Shortened telomere length in bipolar disorder: a comparison of the early and late stages of disease

Barbé-Tuana

Parisi

Panizzutti

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: Bipolar disorder (BD) has been associated with increased rates of age-related diseases, such as type II diabetes, metabolic syndrome, osteoporosis, and cardiovascular disorders. Several biological findings have been associated with age-related disorders, including increased oxidative stress, inflammation, and telomere shortening. The objective of this study was to compare telomere length among participants with BD at early and late stages and age-and gender-matched healthy controls. Methods: Twenty-six euthymic subjects with BD and 34 healthy controls were recruited. Genomic DNA was extracted from peripheral blood and mean telomere length was measured using real-time quantitative polymerase chain reaction. Results: Telomere length was significantly shorter in both the early and late subgroups of BD subjects when compared to the respective controls (p = 0.002 and p = 0.005, respectively). The sample size prevented additional subgroup analyses, including potential effects of medication, smoking status, and lifestyle. Conclusion: This study is concordant with previous evidence of telomere shortening in BD, in both early and late stages of the disorder, and supports the notion of accelerated aging in BD.

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“…3,4 The progression of BD is frequently associated with an increased number of episodes, [5][6][7][8] subclinical symptoms in the interepisodic period, 9,10 higher rates of comorbidities, 11 increased risk of suicide, 12 a higher number of hospital admissions, 13 and poorer response to treatment. 6 Furthermore, several studies have shown a strong association between number of mood episodes and unfavorable clinical outcomes, especially cognitive and functional impairment.…”

Section: Introductionmentioning

confidence: 99%

Neurobiological underpinnings of bipolar disorder focusing on findings of diffusion tensor imaging: a systematic review

Duarte

Silva²,

Goldani³

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: To review the available data on diffusion tensor imaging (DTI) of subjects with bipolar disorder (BD), with a particular focus on fractional anisotropy (FA) in white matter (WM) tracts. Methods: The PubMed/MEDLINE database was searched for relevant articles, which were included in a systematic review of the literature. FA reductions and WM abnormalities were divided anatomically into three groups: commissural tracts, association tracts, and projection tracts. Results: Eighteen studies met the inclusion criteria. The corpus callosum was the main impaired commissural tract as demonstrated by FA reductions. Five studies reported FA reductions in the cingulum. Two studies reported decreased FA in the anterior thalamic radiation, and one in the corticospinal tract. Conversely, three studies found increased FA values in WM tracts involved in BD pathophysiology. Conclusion: Despite considerable heterogeneity, these results indicate a direct link between executive cognitive functioning and abnormal WM microstructural integrity of fronto-limbic tracts in patients with remitted BD, providing further evidence of the neuronal disruption that underlies BD symptomatology.

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

Cited by 186 publications

References 82 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Shortened telomere length in bipolar disorder: a comparison of the early and late stages of disease

Neurobiological underpinnings of bipolar disorder focusing on findings of diffusion tensor imaging: a systematic review

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