Is there a clinical prodrome of bipolar disorder? A review of the evidence

Abstract

Bipolar disorder is a prevalent, chronic and heterogeneous psychiatric disorder. There is increasing evidence that early recognition and treatment can improve long-term outcomes and prevent disability. Early intervention services for schizophrenia are well-funded and developed throughout the UK with close attention paid to the prodromal or early warning signs of schizophrenia, whereas there are currently no clear guidelines on the clinical, biological and neuropsychological markers of early bipolar disorder. This article reviews the growing literature on the bipolar prodrome and the differentiation between the syndromes of unipolar and bipolar depression.

Keywords::

• at-risk mental states
• bipolar
• clinical high risk
• early sign
• early symptoms
• early warning signs
• preclinical
• prediction
• predictive model
• prodromal
• prodrome
• prodromes
• ultra high risk

Financial & competing interests disclosure

DJ Smith has received honoraria for speaking at educational meetings organised by AstraZeneca, Lilly, Bristol-Myers Squib and Lundbeck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.