Advertisement

Staging of Bipolar Disorder

  • Kostas N. Fountoulakis
Chapter

Abstract

After the revolution which was brought with the introduction of operationalized diagnostic criteria by contemporary classification systems, the reliability and the validity of psychiatric diagnosis were greatly improved. Following the improvement in categorical diagnosis, two new needs emerge. The first is to explore all aspects of symptomatology and quantify severity. This is a function addressed with the use of psychometric and neuropsychological tools. There is much improvement in this field although much remains to be done (see Chap. 14). The second and still unfulfilled need is to define and rate seriousness, progression, changes in physiology and damage made and the extent and the specific characteristics of the disease. ‘Staging’ is the term which defines this procedure and it can provide the clinician with a valuable tool to assist the treatment design.

Keywords

BDNF Level Manic Episode Neurocognitive Impairment Unipolar Depression Rapid Cycling 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Alessandra MA, Colom F, Pacchiarotti I, Murru A, Scott J, Valenti M, Mazzarini L, Mar Bonnin CD, Jose SM, Serretti A, Vieta E (2013) Treatment strategies according to clinical features in a naturalistic cohort study of bipolar patients: a principal component analysis of lifetime pharmacological and biophysic treatment options. Eur Neuropsychopharmacol 23(4):263–275Google Scholar
  2. Andreazza AC, Cassini C, Rosa AR, Leite MC, de Almeida LM, Nardin P, Cunha AB, Cereser KM, Santin A, Gottfried C, Salvador M, Kapczinski F, Goncalves CA (2007a) Serum S100B and antioxidant enzymes in bipolar patients. J Psychiatr Res 41(6):523–529. doi: 10.1016/j.jpsychires.2006.07.013 PubMedGoogle Scholar
  3. Andreazza AC, Frey BN, Erdtmann B, Salvador M, Rombaldi F, Santin A, Goncalves CA, Kapczinski F (2007b) DNA damage in bipolar disorder. Psychiatry Res 153(1):27–32. doi: 10.1016/j.psychres.2006.03.025 PubMedGoogle Scholar
  4. Andreazza AC, Kapczinski F, Kauer-Sant’Anna M, Walz JC, Bond DJ, Goncalves CA, Young LT, Yatham LN (2009) 3-Nitrotyrosine and glutathione antioxidant system in patients in the early and late stages of bipolar disorder. J Psychiatry Neurosci 34(4):263–271PubMedCentralPubMedGoogle Scholar
  5. Arango C, Rapado-Castro M, Reig S, Castro-Fornieles J, Gonzalez-Pinto A, Otero S, Baeza I, Moreno C, Graell M, Janssen J, Parellada M, Moreno D, Bargallo N, Desco M (2012) Progressive brain changes in children and adolescents with first-episode psychosis. Arch Gen Psychiatry 69(1):16–26. doi: 10.1001/archgenpsychiatry.2011.150 PubMedGoogle Scholar
  6. Aronson TA, Shukla S, Gujavarty K, Hoff A, DiBuono M, Khan E (1988a) Relapse in delusional depression: a retrospective study of the course of treatment. Compr Psychiatry 29(1):12–21PubMedGoogle Scholar
  7. Aronson TA, Shukla S, Hoff A, Cook B (1988b) Proposed delusional depression subtypes: preliminary evidence from a retrospective study of phenomenology and treatment course. J Affect Disord 14(1):69–74PubMedGoogle Scholar
  8. Bai YM, Su TP, Tsai SJ, Wen-Fei C, Li CT, Pei-Chi T, Mu-Hong C (2014) Comparison of inflammatory cytokine levels among type I/type II and manic/hypomanic/euthymic/depressive states of bipolar disorder. J Affect Disord 166:187–192. doi: 10.1016/j.jad.2014.05.009 PubMedGoogle Scholar
  9. Balanza-Martinez V, Tabares-Seisdedos R, Selva-Vera G, Martinez-Aran A, Torrent C, Salazar-Fraile J, Leal-Cercos C, Vieta E, Gomez-Beneyto M (2005) Persistent cognitive dysfunctions in bipolar I disorder and schizophrenic patients: a 3-year follow-up study. Psychother Psychosom 74(2):113–119. doi: 10.1159/000083170 PubMedGoogle Scholar
  10. Baldessarini RJ, Tondo L, Visioli C (2014) First-episode types in bipolar disorder: predictive associations with later illness. Acta Psychiatr Scand 129(5):383–392. doi: 10.1111/acps.12204 PubMedGoogle Scholar
  11. Berk M (2009) Neuroprogression: pathways to progressive brain changes in bipolar disorder. Int J Neuropsychopharmacol 12(4):441–445. doi: 10.1017/S1461145708009498 PubMedGoogle Scholar
  12. Berk M, Conus P, Lucas N, Hallam K, Malhi GS, Dodd S, Yatham LN, Yung A, McGorry P (2007a) Setting the stage: from prodrome to treatment resistance in bipolar disorder. Bipolar Disord 9(7):671–678. doi: 10.1111/j.1399-5618.2007.00484.x PubMedGoogle Scholar
  13. Berk M, Hallam KT, McGorry PD (2007b) The potential utility of a staging model as a course specifier: a bipolar disorder perspective. J Affect Disord 100(1–3):279–281. doi: 10.1016/j.jad.2007.03.007 PubMedGoogle Scholar
  14. Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI (2008) N-acetyl cysteine for depressive symptoms in bipolar disorder–a double-blind randomized placebo-controlled trial. Biol Psychiatry 64(6):468–475. doi: 10.1016/j.biopsych.2008.04.022 PubMedGoogle Scholar
  15. Berk M, Hallam K, Malhi GS, Henry L, Hasty M, Macneil C, Yucel M, Pantelis C, Murphy B, Vieta E, Dodd S, McGorry PD (2010) Evidence and implications for early intervention in bipolar disorder. J Ment Health 19(2):113–126. doi: 10.3109/09638230903469111 PubMedGoogle Scholar
  16. Berk M, Brnabic A, Dodd S, Kelin K, Tohen M, Malhi GS, Berk L, Conus P, McGorry PD (2011a) Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention. Bipolar Disord 13(1):87–98. doi: 10.1111/j.1399-5618.2011.00889.x PubMedGoogle Scholar
  17. Berk M, Kapczinski F, Andreazza AC, Dean OM, Giorlando F, Maes M, Yucel M, Gama CS, Dodd S, Dean B, Magalhaes PV, Amminger P, McGorry P, Malhi GS (2011b) Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev 35(3):804–817. doi: 10.1016/j.neubiorev.2010.10.001 PubMedGoogle Scholar
  18. Berk M, Berk L, Udina M, Moylan S, Stafford L, Hallam K, Goldstone S, McGorry PD (2012) Palliative models of care for later stages of mental disorder: maximizing recovery, maintaining hope, and building morale. Aust N Z J Psychiatry 46(2):92–99. doi: 10.1177/0004867411432072 PubMedGoogle Scholar
  19. Berk M, Berk L, Dodd S, Cotton S, Macneil C, Daglas R, Conus P, Bechdolf A, Moylan S, Malhi GS (2014) Stage managing bipolar disorder. Bipolar Disord 16(5):471–477. doi: 10.1111/bdi.12099 PubMedGoogle Scholar
  20. Blumberg HP, Krystal JH, Bansal R, Martin A, Dziura J, Durkin K, Martin L, Gerard E, Charney DS, Peterson BS (2006) Age, rapid-cycling, and pharmacotherapy effects on ventral prefrontal cortex in bipolar disorder: a cross-sectional study. Biol Psychiatry 59(7):611–618. doi: 10.1016/j.biopsych.2005.08.031 PubMedGoogle Scholar
  21. Bora E, Fornito A, Yucel M, Pantelis C (2010) Voxelwise meta-analysis of gray matter abnormalities in bipolar disorder. Biol Psychiatry 67(11):1097–1105. doi: 10.1016/j.biopsych.2010.01.020 PubMedGoogle Scholar
  22. Brietzke E, Kapczinski F (2008) TNF-alpha as a molecular target in bipolar disorder. Prog Neuro-Psychopharmacol Biol Psychiatry 32(6):1355–1361. doi: 10.1016/j.pnpbp.2008.01.006 Google Scholar
  23. Brietzke E, Stertz L, Fernandes BS, Kauer-Sant’anna M, Mascarenhas M, Escosteguy Vargas A, Chies JA, Kapczinski F (2009) Comparison of cytokine levels in depressed, manic and euthymic patients with bipolar disorder. J Affect Disord 116(3):214–217. doi: 10.1016/j.jad.2008.12.001 PubMedGoogle Scholar
  24. Carlson GA, Goodwin FK (1973) The stages of mania. A longitudinal analysis of the manic episode. Arch Gen Psychiatry 28(2):221–228PubMedGoogle Scholar
  25. Carvalho AF, Dimellis D, Gonda X, Vieta E, McLntyre RS, Fountoulakis KN (2014) Rapid cycling in bipolar disorder: a systematic review. J Clin Psychiatry 75(6):e578–e586. doi: 10.4088/JCP.13r08905 PubMedGoogle Scholar
  26. Cavanagh JT, Van Beck M, Muir W, Blackwood DH (2002) Case-control study of neurocognitive function in euthymic patients with bipolar disorder: an association with mania. Br J Psychiatry 180:320–326PubMedGoogle Scholar
  27. Chang CC, Jou SH, Lin TT, Liu CS (2014) Mitochondrial DNA variation and increased oxidative damage in euthymic patients with bipolar disorder. Psychiatry Clin Neurosci 68(7):551–557. doi: 10.1111/pcn.12163 PubMedGoogle Scholar
  28. Clark L, Iversen SD, Goodwin GM (2002) Sustained attention deficit in bipolar disorder. Br J Psychiatry 180:313–319PubMedGoogle Scholar
  29. Cosci F, Fava GA (2013) Staging of mental disorders: systematic review. Psychother Psychosom 82(1):20–34. doi: 10.1159/000342243 PubMedGoogle Scholar
  30. Cunha AB, Andreazza AC, Gomes FA, Frey BN, da Silveira LE, Goncalves CA, Kapczinski F (2008) Investigation of serum high-sensitive C-reactive protein levels across all mood states in bipolar disorder. Eur Arch Psychiatry Clin Neurosci 258(5):300–304. doi: 10.1007/s00406-007-0797-0 PubMedGoogle Scholar
  31. Denicoff KD, Ali SO, Mirsky AF, Smith-Jackson EE, Leverich GS, Duncan CC, Connell EG, Post RM (1999) Relationship between prior course of illness and neuropsychological functioning in patients with bipolar disorder. J Affect Disord 56(1):67–73, S0165-0327(99)00028-2 [pii]PubMedGoogle Scholar
  32. Duffy A, Alda M, Hajek T, Sherry SB, Grof P (2010) Early stages in the development of bipolar disorder. J Affect Disord 121(1–2):127–135. doi: 10.1016/j.jad.2009.05.022 PubMedGoogle Scholar
  33. El-Badri SM, Ashton CH, Moore PB, Marsh VR, Ferrier IN (2001) Electrophysiological and cognitive function in young euthymic patients with bipolar affective disorder. Bipolar Disord 3(2):79–87PubMedGoogle Scholar
  34. Fava GA (1999) Subclinical symptoms in mood disorders: pathophysiological and therapeutic implications. Psychol Med 29(1):47–61PubMedGoogle Scholar
  35. Fava GA, Kellner R (1993) Staging: a neglected dimension in psychiatric classification. Acta Psychiatr Scand 87(4):225–230PubMedGoogle Scholar
  36. Fernandes BS, Gama CS, Cereser KM, Yatham LN, Fries GR, Colpo G, de Lucena D, Kunz M, Gomes FA, Kapczinski F (2011) Brain-derived neurotrophic factor as a state-marker of mood episodes in bipolar disorders: a systematic review and meta-regression analysis. J Psychiatr Res 45(8):995–1004. doi: 10.1016/j.jpsychires.2011.03.002 PubMedGoogle Scholar
  37. Fountoulakis KN (2009) An update of evidence-based treatment of bipolar depression: where do we stand? Curr Opin Psychiatry 23(1):19–24. doi: 10.1097/YCO.0b013e328333e132 Google Scholar
  38. Fountoulakis KN (2012) Refractoriness in bipolar disorder: definitions and evidence-based treatment. CNS Neurosci Ther 18(3):227–237. doi: 10.1111/j.1755-5949.2011.00259.x PubMedGoogle Scholar
  39. Fountoulakis KN, Vieta E (2008) Treatment of bipolar disorder: a systematic review of available data and clinical perspectives. Int J Neuropsychopharmacol 11(7):999–1029. doi: 10.1017/S1461145708009231, S1461145708009231 [pii]PubMedGoogle Scholar
  40. Fountoulakis KN, Giannakopoulos P, Kovari E, Bouras C (2008a) Assessing the role of cingulate cortex in bipolar disorder: neuropathological, structural and functional imaging data. Brain Res Rev 59(1):9–21. doi: 10.1016/j.brainresrev.2008.04.005 PubMedGoogle Scholar
  41. Fountoulakis KN, Grunze H, Panagiotidis P, Kaprinis G (2008b) Treatment of bipolar depression: an update. J Affect Disord 109(1-2):21–34. doi: 10.1016/j.jad.2007.10.016, S0165-0327(07)00378-3 [pii]PubMedGoogle Scholar
  42. Fountoulakis KN, Vieta E, Bouras C, Notaridis G, Giannakopoulos P, Kaprinis G, Akiskal H (2008c) A systematic review of existing data on long-term lithium therapy: neuroprotective or neurotoxic? Int J Neuropsychopharmacol 11(2):269–287. doi: 10.1017/S1461145707007821 PubMedGoogle Scholar
  43. Fountoulakis KN, Kelsoe JR, Akiskal H (2011) Receptor targets for antidepressant therapy in bipolar disorder: an overview. J Affect Disord 138(3):222–238. doi: 10.1016/j.jad.2011.04.043, S0165-0327(11)00210-2 [pii]PubMedGoogle Scholar
  44. Frank E, Nimgaonkar VL, Phillips ML, Kupfer DJ (2014) All the world’s a (clinical) stage: rethinking bipolar disorder from a longitudinal perspective. Mol Psychiatry. doi: 10.1038/mp.2014.71 Google Scholar
  45. Fries GR, Pfaffenseller B, Stertz L, Paz AV, Dargel AA, Kunz M, Kapczinski F (2012) Staging and neuroprogression in bipolar disorder. Curr Psychiatry Rep 14(6):667–675. doi: 10.1007/s11920-012-0319-2 PubMedGoogle Scholar
  46. Garcia-Lopez A, De Dios-Perrino C, Ezquiaga E (2009) Polarity of the first episode and predominant polarity in a cohort of bipolar outpatients. Eur Neuropsychopharmacol 19:S571Google Scholar
  47. Gelenberg AJ, Kane JM, Keller MB, Lavori P, Rosenbaum JF, Cole K, Lavelle J (1989) Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder. N Engl J Med 321(22):1489–1493. doi: 10.1056/NEJM198911303212201 PubMedGoogle Scholar
  48. Goodwin F, Jamison K (2007) Manic-depressive illness, 2nd edn. Oxford University Press, New YorkGoogle Scholar
  49. Grande I, Magalhaes PV, Chendo I, Stertz L, Panizutti B, Colpo GD, Rosa AR, Gama CS, Kapczinski F, Vieta E (2014) Staging bipolar disorder: clinical, biochemical, and functional correlates. Acta Psychiatr Scand 129(6):437–444. doi: 10.1111/acps.12268 PubMedGoogle Scholar
  50. Hamilton BA, Naismith SL, Scott EM, Purcell S, Hickie IB (2011) Disability is already pronounced in young people with early stages of affective disorders: data from an early intervention service. J Affect Disord 131(1–3):84–91. doi: 10.1016/j.jad.2010.10.052 PubMedGoogle Scholar
  51. Helms PM, Smith RE (1983) Recurrent psychotic depression. Evidence of diagnostic stability. J Affect Disord 5(1):51–54PubMedGoogle Scholar
  52. Hickie IB, Scott J, Hermens DF, Scott EM, Naismith SL, Guastella AJ, Glozier N, McGorry PD (2013) Clinical classification in mental health at the cross-roads: which direction next? BMC Med 11:125. doi: 10.1186/1741-7015-11-125 PubMedCentralPubMedGoogle Scholar
  53. Insel TR (2010) Rethinking schizophrenia. Nature 468(7321):187–193. doi: 10.1038/nature09552 PubMedGoogle Scholar
  54. Javadapour A, Malhi GS, Ivanovski B, Chen X, Wen W, Sachdev P (2007) Increased anterior cingulate cortex volume in bipolar I disorder. Aust N Z J Psychiatry 41(11):910–916. doi: 10.1080/00048670701634978 PubMedGoogle Scholar
  55. Judd LL, Akiskal HS (2003) The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. J Affect Disord 73(1–2):123–131PubMedGoogle Scholar
  56. Judd LL, Akiskal HS, Schettler PJ, Endicott J, Maser J, Solomon DA, Leon AC, Rice JA, Keller MB (2002) The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 59(6):530–537, yoa20425 [pii]PubMedGoogle Scholar
  57. Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD, Solomon DA, Leon AC, Keller MB (2003) A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry 60(3):261–269, yoa20225 [pii]PubMedGoogle Scholar
  58. Judd LL, Schettler PJ, Akiskal HS, Coryell W, Leon AC, Maser JD, Solomon DA (2008) Residual symptom recovery from major affective episodes in bipolar disorders and rapid episode relapse/recurrence. Arch Gen Psychiatry 65(4):386–394. doi: 10.1001/archpsyc.65.4.386, 65/4/386 [pii]PubMedGoogle Scholar
  59. Juster RP, McEwen BS, Lupien SJ (2010) Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev 35(1):2–16. doi: 10.1016/j.neubiorev.2009.10.002 PubMedGoogle Scholar
  60. Kapczinski F, Frey BN, Andreazza AC, Kauer-Sant’Anna M, Cunha AB, Post RM (2008a) Increased oxidative stress as a mechanism for decreased BDNF levels in acute manic episodes. Rev Bras Psiquiatr 30(3):243–245PubMedGoogle Scholar
  61. Kapczinski F, Vieta E, Andreazza AC, Frey BN, Gomes FA, Tramontina J, Kauer-Sant’anna M, Grassi-Oliveira R, Post RM (2008b) Allostatic load in bipolar disorder: implications for pathophysiology and treatment. Neurosci Biobehav Rev 32(4):675–692. doi: 10.1016/j.neubiorev.2007.10.005 PubMedGoogle Scholar
  62. Kapczinski F, Dias VV, Kauer-Sant’Anna M, Brietzke E, Vazquez GH, Vieta E, Berk M (2009a) The potential use of biomarkers as an adjunctive tool for staging bipolar disorder. Prog Neuro-Psychopharmacol Biol Psychiatry 33(8):1366–1371. doi: 10.1016/j.pnpbp.2009.07.027 Google Scholar
  63. Kapczinski F, Dias VV, Kauer-Sant’Anna M, Frey BN, Grassi-Oliveira R, Colom F, Berk M (2009b) Clinical implications of a staging model for bipolar disorders. Expert Rev Neurother 9(7):957–966. doi: 10.1586/ern.09.31 PubMedGoogle Scholar
  64. Kapczinski F, Dal-Pizzol F, Teixeira AL, Magalhaes PV, Kauer-Sant’Anna M, Klamt F, Pasquali MA, Quevedo J, Gama CS, Post R (2010) A systemic toxicity index developed to assess peripheral changes in mood episodes. Mol Psychiatry 15(8):784–786. doi: 10.1038/mp.2009.112 PubMedGoogle Scholar
  65. Kapczinski F, Dal-Pizzol F, Teixeira AL, Magalhaes PV, Kauer-Sant’Anna M, Klamt F, Moreira JC, de Bittencourt Pasquali MA, Fries GR, Quevedo J, Gama CS, Post R (2011) Peripheral biomarkers and illness activity in bipolar disorder. J Psychiatr Res 45(2):156–161. doi: 10.1016/j.jpsychires.2010.05.015 PubMedGoogle Scholar
  66. Kapczinski F, Magalhaes PV, Balanza-Martinez V, Dias VV, Frangou S, Gama CS, Gonzalez-Pinto A, Grande I, Ha K, Kauer-Sant’Anna M, Kunz M, Kupka R, Leboyer M, Lopez-Jaramillo C, Post RM, Rybakowski JK, Scott J, Strejilevitch S, Tohen M, Vazquez G, Yatham L, Vieta E, Berk M (2014) Staging systems in bipolar disorder: an International Society for Bipolar Disorders Task Force report. Acta Psychiatrica Scand. doi: 10.1111/acps.12305 Google Scholar
  67. Kauer-Sant’Anna M, Kapczinski F, Andreazza AC, Bond DJ, Lam RW, Young LT, Yatham LN (2009) Brain-derived neurotrophic factor and inflammatory markers in patients with early- vs. late-stage bipolar disorder. Int J Neuropsychopharmacol 12(4):447–458. doi: 10.1017/S1461145708009310 PubMedGoogle Scholar
  68. Kendler KS, Thornton LM, Gardner CO (2000) Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the “kindling” hypothesis. Am J Psychiatry 157(8):1243–1251PubMedGoogle Scholar
  69. Ketter TA, Houston JP, Adams DH, Risser RC, Meyers AL, Williamson DJ, Tohen M (2006) Differential efficacy of olanzapine and lithium in preventing manic or mixed recurrence in patients with bipolar I disorder based on number of previous manic or mixed episodes. J Clin Psychiatry 67(1):95–101PubMedGoogle Scholar
  70. Lagopoulos J, Hermens DF, Naismith SL, Scott EM, Hickie IB (2012) Frontal lobe changes occur early in the course of affective disorders in young people. BMC Psychiatry 12:4. doi: 10.1186/1471-244X-12-4 PubMedCentralPubMedGoogle Scholar
  71. Lebowitz BK, Shear PK, Steed MA, Strakowski SM (2001) Verbal fluency in mania: relationship to number of manic episodes. Neuropsychiatr Neuropsychol Behav Neurol 14(3):177–182Google Scholar
  72. Lewandowski KE, Cohen BM, Ongur D (2011) Evolution of neuropsychological dysfunction during the course of schizophrenia and bipolar disorder. Psychol Med 41(2):225–241. doi: 10.1017/S0033291710001042, S0033291710001042 [pii]PubMedGoogle Scholar
  73. Lim CS, Baldessarini RJ, Vieta E, Yucel M, Bora E, Sim K (2013) Longitudinal neuroimaging and neuropsychological changes in bipolar disorder patients: review of the evidence. Neurosci Biobehav Rev 37(3):418–435. doi: 10.1016/j.neubiorev.2013.01.003 PubMedGoogle Scholar
  74. Lin A, Reniers RL, Wood SJ (2013) Clinical staging in severe mental disorder: evidence from neurocognition and neuroimaging. Br J Psychiatry Suppl 54:s11–s17. doi: 10.1192/bjp.bp.112.119156 PubMedGoogle Scholar
  75. Lopez-Jaramillo C, Lopera-Vasquez J, Gallo A, Ospina-Duque J, Bell V, Torrent C, Martinez-Aran A, Vieta E (2010) Effects of recurrence on the cognitive performance of patients with bipolar I disorder: implications for relapse prevention and treatment adherence. Bipolar Disord 12(5):557–567. doi: 10.1111/j.1399-5618.2010.00835.x PubMedGoogle Scholar
  76. Magalhaes PV, Jansen K, Pinheiro RT, Klamt F, Teixeira AL, da Silva RA, Kapczinski F (2011) Systemic toxicity in early-stage mood disorders. J Psychiatr Res 45(10):1407–1409. doi: 10.1016/j.jpsychires.2011.05.008 PubMedGoogle Scholar
  77. Magalhaes PV, Dodd S, Nierenberg AA, Berk M (2012a) Cumulative morbidity and prognostic staging of illness in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Aust N Z J Psychiatry 46(11):1058–1067. doi: 10.1177/0004867412460593 PubMedGoogle Scholar
  78. Magalhaes PV, Jansen K, Pinheiro RT, Colpo GD, da Motta LL, Klamt F, da Silva RA, Kapczinski F (2012b) Peripheral oxidative damage in early-stage mood disorders: a nested population-based case-control study. Int J Neuropsychopharmacol 15(8):1043–1050. doi: 10.1017/S1461145711001532 PubMedGoogle Scholar
  79. McGorry PD (2007) Issues for DSM-V: clinical staging: a heuristic pathway to valid nosology and safer, more effective treatment in psychiatry. Am J Psychiatry 164(6):859–860. doi: 10.1176/appi.ajp.164.6.859 PubMedGoogle Scholar
  80. McGorry PD (2010a) Risk syndromes, clinical staging and DSM V: new diagnostic infrastructure for early intervention in psychiatry. Schizophr Res 120(1–3):49–53. doi: 10.1016/j.schres.2010.03.016 PubMedGoogle Scholar
  81. McGorry PD (2010b) Staging in neuropsychiatry: a heuristic model for understanding, prevention and treatment. Neurotox Res 18(3–4):244–255. doi: 10.1007/s12640-010-9179-x PubMedGoogle Scholar
  82. McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ (2006) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 40(8):616–622. doi: 10.1111/j.1440-1614.2006.01860.x PubMedGoogle Scholar
  83. McGorry PD, Purcell R, Hickie IB, Yung AR, Pantelis C, Jackson HJ (2007) Clinical staging: a heuristic model for psychiatry and youth mental health. Med J Aust 187(7 Suppl):S40–S42PubMedGoogle Scholar
  84. McGorry PD, Killackey E, Yung A (2008) Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry 7(3):148–156PubMedCentralPubMedGoogle Scholar
  85. McGorry PD, Nelson B, Goldstone S, Yung AR (2010) Clinical staging: a heuristic and practical strategy for new research and better health and social outcomes for psychotic and related mood disorders. Can J Psychiatry 55(8):486–497PubMedGoogle Scholar
  86. McIntyre RS, Correll C (2014) Predicting and preventing bipolar disorder: the need to fundamentally advance the strategic approach. Bipolar Disord 16(5):451–454. doi: 10.1111/bdi.12216 PubMedGoogle Scholar
  87. McNamara RK, Nandagopal JJ, Strakowski SM, DelBello MP (2010) Preventative strategies for early-onset bipolar disorder: towards a clinical staging model. CNS Drugs 24(12):983–996. doi: 10.2165/11539700-000000000-00000 PubMedGoogle Scholar
  88. Moore PB, Shepherd DJ, Eccleston D, Macmillan IC, Goswami U, McAllister VL, Ferrier IN (2001) Cerebral white matter lesions in bipolar affective disorder: relationship to outcome. Br J Psychiatry 178:172–176PubMedGoogle Scholar
  89. Moorhead TW, McKirdy J, Sussmann JE, Hall J, Lawrie SM, Johnstone EC, McIntosh AM (2007) Progressive gray matter loss in patients with bipolar disorder. Biol Psychiatry 62(8):894–900. doi: 10.1016/j.biopsych.2007.03.005 PubMedGoogle Scholar
  90. Munkholm K, Poulsen HE, Kessing LV, Vinberg M (2014) Elevated levels of urinary markers of oxidatively generated DNA and RNA damage in bipolar disorder. Bipolar Disord. doi: 10.1111/bdi.12245 PubMedGoogle Scholar
  91. Nelson WH, Khan A, Orr WW Jr (1984) Delusional depression. Phenomenology, neuroendocrine function, and tricyclic antidepressant response. J Affect Disord 6(3–4):297–306PubMedGoogle Scholar
  92. Nery FG, Chen HH, Hatch JP, Nicoletti MA, Brambilla P, Sassi RB, Mallinger AG, Keshavan MS, Soares JC (2009) Orbitofrontal cortex gray matter volumes in bipolar disorder patients: a region-of-interest MRI study. Bipolar Disord 11(2):145–153. doi: 10.1111/j.1399-5618.2009.00662.x PubMedGoogle Scholar
  93. Perry A, Tarrier N, Morriss R, McCarthy E, Limb K (1999) Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. BMJ 318(7177):149–153PubMedCentralPubMedGoogle Scholar
  94. Popovic D, Vieta E (2013) Clinical implications of polarity index of drugs in maintenance treatment of bipolar disorder: a naturalistic study. Eur Neuropsychopharmacol 23:S68–S69Google Scholar
  95. Post RM (1992) Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 149(8):999–1010PubMedGoogle Scholar
  96. Post RM (2010) Mechanisms of illness progression in the recurrent affective disorders. Neurotox Res 18(3–4):256–271. doi: 10.1007/s12640-010-9182-2 PubMedGoogle Scholar
  97. Post RM, Denicoff KD, Leverich GS, Altshuler LL, Frye MA, Suppes TM, Rush AJ, Keck PE Jr, McElroy SL, Luckenbaugh DA, Pollio C, Kupka R, Nolen WA (2003) Morbidity in 258 bipolar outpatients followed for 1 year with daily prospective ratings on the NIMH life chart method. J Clin Psychiatry 64(6):680–690; quiz 738–789PubMedGoogle Scholar
  98. Post RM, Altshuler LL, Frye MA, Suppes T, Keck PE Jr, McElroy SL, Leverich GS, Luckenbaugh DA, Rowe M, Pizzarello S, Kupka RW, Grunze H, Nolen WA (2010) Complexity of pharmacologic treatment required for sustained improvement in outpatients with bipolar disorder. J Clin Psychiatry 71(9):1176–1186. doi: 10.4088/JCP.08m04811yel; quiz 1252–1273PubMedGoogle Scholar
  99. Post RM, Fleming J, Kapczinski F (2012) Neurobiological correlates of illness progression in the recurrent affective disorders. J Psychiatr Res 46(5):561–573. doi: 10.1016/j.jpsychires.2012.02.004 PubMedGoogle Scholar
  100. Ranjekar PK, Hinge A, Hegde MV, Ghate M, Kale A, Sitasawad S, Wagh UV, Debsikdar VB, Mahadik SP (2003) Decreased antioxidant enzymes and membrane essential polyunsaturated fatty acids in schizophrenic and bipolar mood disorder patients. Psychiatry Res 121(2):109–122PubMedGoogle Scholar
  101. Reinares M, Colom F, Rosa AR, Bonnin CM, Franco C, Sole B, Kapczinski F, Vieta E (2010) The impact of staging bipolar disorder on treatment outcome of family psychoeducation. J Affect Disord 123(1–3):81–86. doi: 10.1016/j.jad.2009.09.009 PubMedGoogle Scholar
  102. Reinares M, Papachristou E, Harvey P, Mar Bonnin C, Sanchez-Moreno J, Torrent C, Ayuso-Mateos JL, Ploubidis GB, Vieta E, Frangou S (2013) Towards a clinical staging for bipolar disorder: defining patient subtypes based on functional outcome. J Affect Disord 144(1–2):65–71. doi: 10.1016/j.jad.2012.06.005 PubMedGoogle Scholar
  103. Robinson LJ, Ferrier IN (2006) Evolution of cognitive impairment in bipolar disorder: a systematic review of cross-sectional evidence. Bipolar Disord 8(2):103–116. doi: 10.1111/j.1399-5618.2006.00277.x, BDI277 [pii]PubMedGoogle Scholar
  104. Rosa AR, Frey BN, Andreazza AC, Cereser KM, Cunha AB, Quevedo J, Santin A, Gottfried C, Goncalves CA, Vieta E, Kapczinski F (2006) Increased serum glial cell line-derived neurotrophic factor immunocontent during manic and depressive episodes in individuals with bipolar disorder. Neurosci Lett 407(2):146–150. doi: 10.1016/j.neulet.2006.08.026 PubMedGoogle Scholar
  105. Rosa AR, Gonzalez-Ortega I, Gonzalez-Pinto A, Echeburua E, Comes M, Martinez-Aran A, Ugarte A, Fernandez M, Vieta E (2012) One-year psychosocial functioning in patients in the early vs. late stage of bipolar disorder. Acta Psychiatr Scand 125(4):335–341. doi: 10.1111/j.1600-0447.2011.01830.x PubMedGoogle Scholar
  106. Rosa AR, Magalhaes PV, Czepielewski L, Sulzbach MV, Goi PD, Vieta E, Gama CS, Kapczinski F (2014) Clinical staging in bipolar disorder: focus on cognition and functioning. J Clin Psychiatry 75(5):e450–e456. doi: 10.4088/JCP.13m08625 PubMedGoogle Scholar
  107. Scott J, Paykel E, Morriss R, Bentall R, Kinderman P, Johnson T, Abbott R, Hayhurst H (2006) Cognitive-behavioural therapy for severe and recurrent bipolar disorders: randomised controlled trial. Br J Psychiatry 188:313–320. doi: 10.1192/bjp.188.4.313 PubMedGoogle Scholar
  108. Scott J, Leboyer M, Hickie I, Berk M, Kapczinski F, Frank E, Kupfer D, McGorry P (2013) Clinical staging in psychiatry: a cross-cutting model of diagnosis with heuristic and practical value. Br J Psychiatry 202(4):243–245. doi: 10.1192/bjp.bp.112.110858 PubMedGoogle Scholar
  109. Segal ZV, Williams JM, Teasdale JD, Gemar M (1996) A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder. Psychol Med 26(2):371–380PubMedGoogle Scholar
  110. Silverstone T, McPherson H, Li Q, Doyle T (2003) Deep white matter hyperintensities in patients with bipolar depression, unipolar depression and age-matched control subjects. Bipolar Disord 5(1):53–57PubMedGoogle Scholar
  111. Simon NM, Smoller JW, McNamara KL, Maser RS, Zalta AK, Pollack MH, Nierenberg AA, Fava M, Wong KK (2006) Telomere shortening and mood disorders: preliminary support for a chronic stress model of accelerated aging. Biol Psychiatry 60(5):432–435. doi: 10.1016/j.biopsych.2006.02.004 PubMedGoogle Scholar
  112. Soares JC, Kochunov P, Monkul ES, Nicoletti MA, Brambilla P, Sassi RB, Mallinger AG, Frank E, Kupfer DJ, Lancaster J, Fox P (2005) Structural brain changes in bipolar disorder using deformation field morphometry. Neuroreport 16(6):541–544PubMedGoogle Scholar
  113. Strakowski SM, Wilson DR, Tohen M, Woods BT, Douglass AW, Stoll AL (1993) Structural brain abnormalities in first-episode mania. Biol Psychiatry 33(8–9):602–609PubMedGoogle Scholar
  114. Strakowski SM, DelBello MP, Zimmerman ME, Getz GE, Mills NP, Ret J, Shear P, Adler CM (2002) Ventricular and periventricular structural volumes in first- versus multiple-episode bipolar disorder. Am J Psychiatry 159(11):1841–1847PubMedGoogle Scholar
  115. Strejilevich SA, Martino DJ (2013) Cognitive function in adulthood and elderly euthymic bipolar patients: a comparison to test models of cognitive evolution. J Affect Disord 150(3):1188–1191. doi: 10.1016/j.jad.2013.05.012 PubMedGoogle Scholar
  116. Swann AC, Bowden CL, Calabrese JR, Dilsaver SC, Morris DD (1999) Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry 156(8):1264–1266PubMedGoogle Scholar
  117. Tohen M, Vieta E, Gonzalez-Pinto A, Reed C, Lin D, European Mania in Bipolar Longitudinal Evaluation of Medication Advisory B (2010) Baseline characteristics and outcomes in patients with first episode or multiple episodes of acute mania. J Clin Psychiatry 71(3):255–261. doi: 10.4088/JCP.08m04580 PubMedGoogle Scholar
  118. Torrent C, Bonnin Cdel M, Martinez-Aran A, Valle J, Amann BL, Gonzalez-Pinto A, Crespo JM, Ibanez A, Garcia-Portilla MP, Tabares-Seisdedos R, Arango C, Colom F, Sole B, Pacchiarotti I, Rosa AR, Ayuso-Mateos JL, Anaya C, Fernandez P, Landin-Romero R, Alonso-Lana S, Ortiz-Gil J, Segura B, Barbeito S, Vega P, Fernandez M, Ugarte A, Subira M, Cerrillo E, Custal N, Menchon JM, Saiz-Ruiz J, Rodao JM, Isella S, Alegria A, Al-Halabi S, Bobes J, Galvan G, Saiz PA, Balanza-Martinez V, Selva G, Fuentes-Dura I, Correa P, Mayoral M, Chiclana G, Merchan-Naranjo J, Rapado-Castro M, Salamero M, Vieta E (2013) Efficacy of functional remediation in bipolar disorder: a multicenter randomized controlled study. Am J Psychiatry 170(8):852–859. doi: 10.1176/appi.ajp.2012.12070971 PubMedGoogle Scholar
  119. Torres IJ, DeFreitas VG, DeFreitas CM, Kauer-Sant’Anna M, Bond DJ, Honer WG, Lam RW, Yatham LN (2010) Neurocognitive functioning in patients with bipolar I disorder recently recovered from a first manic episode. J Clin Psychiatry 71(9):1234–1242. doi: 10.4088/JCP.08m04997yel PubMedGoogle Scholar
  120. Vieta E, Reinares M, Rosa AR (2011) Staging bipolar disorder. Neurotox Res 19(2):279–285. doi: 10.1007/s12640-010-9197-8 PubMedGoogle Scholar
  121. Vieta E, Popovic D, Rosa AR, Sole B, Grande I, Frey BN, Martinez-Aran A, Sanchez-Moreno J, Balanza-Martinez V, Tabares-Seisdedos R, Kapczinski F (2013) The clinical implications of cognitive impairment and allostatic load in bipolar disorder. E Psychiatry 28(1):21–29. doi: 10.1016/j.eurpsy.2011.11.007 Google Scholar
  122. Vita A, De Peri L, Sacchetti E (2009) Gray matter, white matter, brain, and intracranial volumes in first-episode bipolar disorder: a meta-analysis of magnetic resonance imaging studies. Bipolar Disord 11(8):807–814. doi: 10.1111/j.1399-5618.2009.00759.x PubMedGoogle Scholar
  123. Walz JC, Andreazza AC, Frey BN, Cacilhas AA, Cereser KM, Cunha AB, Weyne F, Stertz L, Santin A, Goncalves CA, Kapczinski F (2007) Serum neurotrophin-3 is increased during manic and depressive episodes in bipolar disorder. Neurosci Lett 415(1):87–89. doi: 10.1016/j.neulet.2007.01.002 PubMedGoogle Scholar
  124. Walz JC, Magalhaes PV, Giglio LM, Cunha AB, Stertz L, Fries GR, Andreazza AC, Kapczinski F (2009) Increased serum neurotrophin-4/5 levels in bipolar disorder. J Psychiatr Res 43(7):721–723. doi: 10.1016/j.jpsychires.2008.10.005 PubMedGoogle Scholar
  125. Yatham LN, Kapczinski F, Andreazza AC, Trevor Young L, Lam RW, Kauer-Sant’anna M (2009) Accelerated age-related decrease in brain-derived neurotrophic factor levels in bipolar disorder. Int J Neuropsychopharmacol 12(1):137–139. doi: 10.1017/S1461145708009449 PubMedGoogle Scholar
  126. Yung AR, McGorry PD (1996) The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 22(2):353–370PubMedGoogle Scholar
  127. Yung AR, McGorry PD (2007) Prediction of psychosis: setting the stage. Br J Psychiatry Suppl 51:s1–s8. doi: 10.1192/bjp.191.51.s1 PubMedGoogle Scholar
  128. Zubieta JK, Huguelet P, O’Neil RL, Giordani BJ (2001) Cognitive function in euthymic bipolar I disorder. Psychiatry Res 102(1):9–20, S0165-1781(01)00242-6 [pii]PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Kostas N. Fountoulakis
    • 1
  1. 1.Division of Neurosciences 3rd Department of PsychiatryAristotle University of Thessaloniki School of MedicineThessalonikiGreece

Personalised recommendations