Effects of Early Intervention on the Course of Bipolar Disorder: Theories and Realities

Pavuluri, Mani N.

doi:10.1007/s11920-010-0155-1

Cited by 13 publications

(22 citation statements)

References 47 publications

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“…Even more recently, several articles focused specifically on children and adolescents 19,20,26 . Across these reviews, the lack of specificity of prodromal symptoms has been bemoaned.…”

Section: Resultsmentioning

confidence: 99%

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Hauser

Correll

2013

Can J Psychiatry

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Background While in the early identification and intervention of psychosis, specific instruments and risk criteria have been generated and validated, research into preventive strategies for bipolar-I disorder (BP-I) has only recently gained momentum. Since first signs of BP-I often start before adulthood, such efforts are especially important in the vulnerable pediatric population. Methods Narrative review of data regarding the presence and nature of potentially prodromal, i.e., sub-syndromal, symptoms prior to BP-I, defined by first-episode mania, focusing on pediatric patients. Results The possibility of early identification of youth at high-risk for BP is supported by retrospective studies of BP-I patients, and prospective studies of community samples, offspring of BP-I subjects, youth with depressive disorders, and patients at high-risk for psychosis or with BP-spectrum disorders without lifetime history of mania. These data provide essential insight into potential signs and symptoms that may enable pre-syndromal identification of BP-I in youth. However, except for offspring studies, broader prospective approaches that focus on youth at risk for BP-I and on developing specific interviews/rating scales and risk criteria are mostly missing, or in their early stage. Conclusions More work is needed to determine valid clinical high-risk criteria, to distinguish risk factors, endophenotypes and comorbidities from specific prodromal symptomatology, and to develop phase-specific interventions that titrate the risk of intervention to the risk of transition to mania and to functional impairment or distress. Moreover, studies are needed that determine potential differences in prodromal symptoms and trajectories between children, adolescents and adults, and the best phase-specific interventions.

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“…Even more recently, several articles focused specifically on children and adolescents 19,20,26 . Across these reviews, the lack of specificity of prodromal symptoms has been bemoaned.…”

Section: Resultsmentioning

confidence: 99%

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Hauser

Correll

2013

Can J Psychiatry

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“…Children with "prodromal" or "high-risk" forms of BD, such as brief and recurrent manic or hypomanic episodes with a clear change in functioning, are just as impaired as children with full BD I or BD II disorder over 2-to 4-year follow-ups [7, 8••]. Like bipolar adults, children with BD have significant trait-like cognitive impairments, including problems in executive functioning, verbal memory, response flexibility, processing speed, reversal learning, and set shifting [17].…”

Section: Introductionmentioning

confidence: 99%

Functional Impairment, Stress, and Psychosocial Intervention in Bipolar Disorder

Miklowitz¹

2011

Curr Psychiatry Rep

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The longitudinal course of bipolar disorder (BD) is highly impairing. This article reviews recent research on functional impairment in the course of BD, the roles of social and intrafamilial stress in relapse and recovery, and the role of adjunctive psychosocial interventions in reducing risk and enhancing functioning. Comparative findings in adult and childhood BD are highlighted. Life events and family-expressed emotion have emerged as significant predictors of the course of BD. Studies of social information processing suggest that impairments in the recognition of facial emotions may characterize both adult- and early-onset bipolar patients. Newly developed psychosocial interventions, particularly those that focus on family and social relationships, are associated with more rapid recovery from episodes and better psychosocial functioning. Family-based psychoeducational approaches are promising as early interventions for children with BD or children at risk of developing the disorder. For adults, interpersonal therapy, mindfulness-based strategies, and cognitive remediation may offer promise in enhancing functioning.

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“…Juvenile onset generally appears to be common, reportedly ranging from 39% to 65% of samples including patients evaluated as juveniles or adults 2,4,5,6,7. BPD patients with early onset may represent a phenotype of special interest for genetic and other biomedical research, as well as having potential clinical importance 8,9,10,11. Genetic interest arises in part from relatively high rates of familial mood disorders in BPD, generally, and particularly in association with young onset 5,6,7,8,9,10,11.…”

mentioning

confidence: 99%

Age at onset versus family history and clinical outcomes in 1,665 international bipolar‐I disorder patients

Baldessarini¹,

Tondo²,

Vázquez³

et al. 2012

World Psychiatry

157

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Effects of Early Intervention on the Course of Bipolar Disorder: Theories and Realities

Cited by 13 publications

References 47 publications

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Functional Impairment, Stress, and Psychosocial Intervention in Bipolar Disorder

Age at onset versus family history and clinical outcomes in 1,665 international bipolar‐I disorder patients

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