Recognition of bipolar disorder type I before the first manic episode: challenges and developments

Mariane Nunes Noto Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil. [email protected]; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil. [email protected]; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

Cristiano de Souza Noto Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

Danilo Rocha de Jesus Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada

André Zugman Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

Rodrigo B Mansur Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

Arthur A Berberian Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

Emilie Leclerc Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

Roger S McIntyre Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada

Christoph U Correll Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA; Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA; Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA

Elisa Brietzke Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in at Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil

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Abstract

Bipolar disorder (BD) usually follows a neurobiological progression pathway, but a relatively long interval between the first symptoms of the disorder and the correct diagnosis and treatment takes place in most patients. Strategies used to recognize BD at an early stage and even prior to the first manic episode could help identify the risk and modifying factors that influence the onset and course of disease, and improve outcomes. Drawing on current research results, this article presents considerations on risk factors for the development of BD, including genetic/familial risk, endophenotypes and clinical characteristics. Taken together, this article provides a framework and tools for research on the BD prodrome, as well as for the early recognition and timely treatment of patients prior to and immediately after the emergence of BD.

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Notes

Data taken from Citation[82].

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Recognition of bipolar disorder type I before the first manic episode: challenges and developments

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Recognition of bipolar disorder type I before the first manic episode: challenges and developments

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