Rationale and First Results of Developing At-Risk (Prodromal) Criteria for Bipolar Disorder
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Bipolar affective disorder (BD) is a severe, recurrent and disabling disorder with devastating consequences for individuals, families and society. Although these hazards and costs provide a compelling rationale for development of early detection and early intervention strategies in BD, the development of at-risk criteria for first episode mania is still in an early stage of development. In this paper we review the literature with respect to the clinical, neuroantomical and neuropsychological data, which support this goal. We also describe our recently developed bipolar at-risk criteria (BAR). This criteria comprises the peak age range of the first onset of bipolar disorder, genetic risk, presenting with sub-threshold mania, cyclothymic features or depressive symptoms. An initial pilot evaluation of the BAR criteria in 22 subjects indicated conversion rates to proxies of first-episode mania of 23% within 265 days on average, and high specificity and sensitivity of the criteria. If prospective studies confirm the validity of the BAR criteria, then the criteria would have the potential to open up new avenues of research for indicated prevention in BD and might therefore offer opportunities to ameliorate the severity of, or even prevent BD.
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Indicated prevention in bipolar disorder was developed only fifteen years ago and is rapidly emerging, but its supporting evidence lags behind that for CHR-P.
“Indicated prevention in bipolar disorder was developed, following the CHR-P template, only fifteen years ago 96,97 , and is rapidly emerging 98-101 . The supporting evidence lags behind that for CHR-P 99,102 .”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [96]
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Self-citationEarliest symptoms discriminating juvenile‐onset bipolar illness from ADHD
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Altering the course of schizophrenia: progress and perspectives
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Gray Matter Volumetric Abnormalities Associated with the Onset of Psychosis
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Self-citationInstruments that prospectively predict bipolar disorder – A systematic review
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Self-citationAt-risk symptoms of bipolar disorder in a university student cohort
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Influence of early childhood trauma on risk for bipolar disorder
Levandowski, M. L., & Grassi‐Oliveira, R. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-812347-8.00003-8 · Cited by 5 · see citing works
Kafalı, H. Y., Solerdelcoll, M., Vujinovic, L., Martsenkovskyi, D., Awhangansi, S., Noel, C. E., Bora, E., & Arango, C. (2021) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-021-01897-1 · Cited by 3 · see citing works
Early Intervention in Bipolar Disorder
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Self-citationCatching the Storm Before It Breaks: Advancing Early Diagnosis and Intervention in Bipolar Disorder
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Creativity and transition to bipolar disorder: a prospective analysis from the early-bipolife study
Michaelis, E., Bauer, M., Bechdolf, A., Bermpohl, F., Berndt, C., Bröckel, K. L., Burkhardt, E., Correll, C. U., Dannlowski, U., Falkenberg, I., et al. (2025) · International Journal of Bipolar Disorders · doi:10.1186/s40345-025-00406-6 · Cited by 1 · see citing works
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Self-citation
- Authors
- Bechdolf, A., Ratheesh, A., J. Wood, S., Tecic, T., Conus, P., Nelson, B., M. Cotton, S., M. Chanen, A., P. Amminger, G., Ruhrmann, S., Schultze-Lutter, F., Klosterkotter, J., Fusar Poli, P., R. Yung, A., Berk, M., & D. McGorry, P.
- Affiliations
- University of Cologne (DE)
- The University of Melbourne (AU)
- Venue
- Current Pharmaceutical Design
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2012-02-01
- Volume
- 18
- Issue
- 4
- Pages
- 358-375
- ISSN
- 1381-6128 (ISSN-L)
- OpenAlex
- W2167209772
- Cited by
- 82
- References
- 113
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 3 · 2021: 7 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 8 · 2016: 8 · 2015: 6 · 2014: 11 · 2013: 11 · 2012: 8
- FWCI
- 8.20
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- Current Pharmaceutical Design (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- BORIS (University Library Bern) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- bipolar disorder, first-episode mania, early detection, early intervention, depressive symptoms, genetic risk, prevention
- MeSH terms
- Bipolar Disorder, Humans, Neuropsychological Tests, Psychiatric Status Rating Scales, Retrospective Studies, Risk Factors, Early Diagnosis
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