Risk Calculators in Bipolar Disorder: A Systematic Review.

Joana Silva Ribeiro,Nuno Madeira,Eduard Vieta,Estela Salagre,Manuel Coroa,Pedro Santos Oliveira,Daniela Pereira,Iria Grande,Vítor Santos

doi:10.3390/brainsci10080525

Abstract

Introduction: Early recognition of bipolar disorder improves the prognosis and decreases the burden of the disease. However, there is a significant delay in diagnosis. Multiple risk factors for bipolar disorder have been identified and a population at high-risk for the disorder has been more precisely defined. These advances have allowed the development of risk calculators to predict individual risk of conversion to bipolar disorder. This review aims to identify the risk calculators for bipolar disorder and assess their clinical applicability. Methods: A systematic review of original studies on the development of risk calculators in bipolar disorder was performed. The studies’ quality was evaluated with the Newcastle-Ottawa Quality Assessment Form for Cohort Studies and according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis Initiative. Results: Three studies met the inclusion criteria; one developed a risk calculator of conversion from major depressive episode to bipolar disorder; one of conversion to new-onset bipolar spectrum disorders in offspring of parents with bipolar disorder; and the last one of conversion in youths with bipolar disorder not-otherwise-specified. Conclusions: The calculators reviewed in this article present good discrimination power for bipolar disorder, although future replication and validation of the models is needed.

Highlights

Recognition of bipolar disorder improves the prognosis and decreases the burden of the disease
Brain Sci. 2020, 10, 525 unipolar depression. This difficulty is due to several factors, such as: (1) first mood episode is depressive in half of the patients; (2) bipolar patients spend more time with depressive symptoms than with manic symptoms; (3) the search for help is more frequent in depressive episodes; (4) hypomanic episodes or mixed symptoms often go unrecognized [5,6,7,8,9]
This study aims to review all the risk calculators developed for Bipolar disorder (BP), namely, what variables they evaluated, their predictive value, and their main limitations

Summary

Introduction

Recognition of bipolar disorder improves the prognosis and decreases the burden of the disease. It is largely recognized that an early intervention improves the prognosis and decreases the burden of the disease, there is still an important delay between illness onset and diagnosis, with an average delay of 5–10 years [5,6]. Brain Sci. 2020, 10, 525 unipolar depression This difficulty is due to several factors, such as: (1) first mood episode is depressive in half of the patients; (2) bipolar patients spend more time with depressive symptoms than with manic symptoms; (3) the search for help is more frequent in depressive episodes; (4) hypomanic episodes or mixed symptoms often go unrecognized [5,6,7,8,9].

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