Abstract
The early recognition of psychiatric disorders has been a focus of research in the last decades and has led to improvements in clinical care, especially in the area of early psychosis. Like non-affective psychosis, bipolar disorders are often diagnosed with a delay that can lead to long periods of untreated illness and impact long-term outcomes. This article presents the rationale for early recognition in bipolar disorder and presents the current evidence for the identification of risk factors, their assessment and validity in predicting the onset of bipolar disorder.
Highlights
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Prospective studies in young people with a family history of bipolar disorder have aimed to improve the understanding of different trajectories and identify prodromal symptoms [3,24]
Family history of bipolar disorder can only explain part of the variability in risk for the disorder [27] and family history of major depression, schizophrenia or schizoaffective disorder increases the risk of developing bipolar disorder as these conditions appear to have strong genetic correlations [22,28,29]
Summary
Bipolar disorder is often diagnosed with a long latency. Up to ten years lie between a first episode and the start of adequate treatment [1,2]. Clinical services need to facilitate early recognition of bipolar disorder and, ideally, the identification of people at risk for the development of the disorder to offer tailored support appropriate for the stage of illness [17,18]. As bipolar disorder often manifests during adolescence and early adulthood, it can interrupt a crucial developmental period and cause long-term social and occupational difficulties, like delayed or failed completion of education and difficulty in forming lasting friendships or romantic relationships. Intervention should aim to reduce symptoms, and improve psychosocial functioning, by potentially preventing or delaying the onset of bipolar disorder and supporting young people and their families to effectively manage the risk of future episodes [19,20,21]
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