期刊
ACTA PSYCHIATRICA SCANDINAVICA
卷 130, 期 5, 页码 354-363出版社
WILEY
DOI: 10.1111/acps.12305
关键词
bipolar disorder; clinical aspects; early intervention
类别
资金
- AstraZeneca
- Eli Lilly
- Servier
- CNPq
- CAPES
- NARSAD
- Stanley Medical Research Institute
- Lundbeck
- Sanofi-Aventis
- Astra Zeneca
- BMS-Otsuka
- GSK
- Jansen-Cilag
- Adamed
- Alexza
- Almirall
- Bial
- Bristol-Myers Squibb
- Elan
- Ferrer
- Forest Research Institute
- Gedeon Richter
- Glaxo-Smith-Kline
- Janssen-Cilag
- Jazz, Johnson Johnson
- Merck
- Novartis
- Organon
- Otsuk
- Pfizer
- Pierre-Fabre
- Qualigen
- Roche
- Shering-Plough
- Shire
- Solvay
- Sunovion
- Takeda
- Teva
- Spanish Ministry of Science and Innovation (CIBERSAM)
- Seventh European Framework Programme (ENBREC)
- United Biosource Corporation
- Wyeth
- NIH
- Cooperative Research Centre
- Simons Autism Foundation
- Cancer Council of Victoria
- Stanley Medical Research Foundation
- MBF
- NHMRC
- Beyond Blue
- Rotary Health
- Geelong Medical Research Foundation
- Glaxo Smith-Kline
- Meat and Livestock Board
- Mayne Pharma
- Woolworths
- CIHR
- CANMAT
- GlaxoSmithKline
- Janssen
- Michael Smith Foundation for Health Research
- Sanofi
- SMRI
- Universal-CNPq
- CNPq/INCT-TM
- FIPE-HCPA
- Colciencias
- Universidad de Antioquia
- NIMH
- Abbott
- Glaxo SmithKline
- Janssen Cilag
- Sanofi Synthelabo
- [CM12/00062]
ObjectiveWe discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined. MethodWe reviewed the literature pertaining to bipolar disorders, focusing on the first episode onwards. We systematically searched data on staging models for bipolar disorders and allied studies that could inform the concept of staging. ResultsWe report on several dimensions that are relevant to staging concepts in bipolar disorder. We consider whether staging offers a refinement to current diagnoses by reviewing clinical studies of treatment and functioning and the potential utility of neurocognitive, neuroimaging and peripheral biomarkers. ConclusionMost studies to date indicate that globally defined late-stage patients have a worse overall prognosis and poorer response to standard treatment, consistent with patterns for end-stage medical disorders. We believe it is possible at this juncture to speak broadly of early'- and late'-stage bipolar disorder. Next steps require further collaborative efforts to consider the details of preillness onset and intermediary stages, and how many additional stages are optimal.
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