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

Lookup NU author(s): Emeritus Professor Jan Scott


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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.

Publication metadata

Author(s): Kapczinski F, Magalhaes PVS, 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

Publication type: Review

Publication status: Published

Journal: Acta Psychiatrica Scandinavica

Year: 2014

Volume: 130

Issue: 5

Pages: 354-363

Print publication date: 01/11/2014

Online publication date: 25/06/2014

ISSN (print): 0001-690X

ISSN (electronic): 1600-0447



DOI: 10.1111/acps.12305

PubMed id: 24961757