Is there a clinical prodromal period for bipolar disorder?

Abstract

Bipolar disorder (BD) is a prevalent, chronic and heterogeneous psychiatric disorder. The diagnosis of BD, is often delayed and the development of the disorder is associated with suicidal behavior. Growing evidence from both preclinical and clinical literature, points to a clear need for improved early intervention in BD. Individuals who develop BD are often afflicted during their most vulnerable and formative years. A major factor contributing to the burden of disease is the substantial delay between the first experience of symptoms and the initiation of the treatment. Early stage or prodromal BD should be considered in clinical, neuropsychological and biological terms. Early interventions may prevent the development of the full disorder, or at least improve the outcome. The initial prodrome of BD is characterized by disregulation of mood and energy. Large scale longitudinal studies which have control groups are needed to validate these features and characterize their specificity and sensitivity.