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Do we need to flick the switch? The need for a broader conceptualization of iatrogenic course aggravation in clinical trials of bipolar disorder?

Berk, Michael, Ng, Felicity, Dodd, Seetal, Goldberg, Joseph F. and Malhi, Gin S. 2010, Do we need to flick the switch? The need for a broader conceptualization of iatrogenic course aggravation in clinical trials of bipolar disorder?, Psychiatry and clinical neurosciences, vol. 64, no. 4, pp. 367-371.

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Title Do we need to flick the switch? The need for a broader conceptualization of iatrogenic course aggravation in clinical trials of bipolar disorder?
Author(s) Berk, Michael
Ng, Felicity
Dodd, Seetal
Goldberg, Joseph F.
Malhi, Gin S.
Journal name Psychiatry and clinical neurosciences
Volume number 64
Issue number 4
Start page 367
End page 371
Publisher Wiley - Blackwell Publishing Asia
Place of publication Richmond, Vic.
Publication date 2010-08
ISSN 1323-1316
1440-1819
1341-0695
Keyword(s) bipolar disorder
cycling
clinical trial
course
switching
Summary The term ‘switching’ is often used in bipolar disorder when describing polarity changes in bipolar disorder, but this term is ambiguous and imprecise, and is sometimes used interchangeably with the term ‘cycling’. Furthermore, polarity changes in bipolar disorder can be understood in different ways, because their clinical manifestations range from the emergence of subthreshold symptoms to a full episode of the opposite pole. Besides the need to tighten the meaning of the term ‘switching’, this paper also argues that switching does not adequately describe the complex phenomena that occur with course aggravation of bipolar disorder, such as alteration in episode frequency or amplitude. A more-fine grained approach to course aggravation in bipolar disorder is proposed, which incorporates trans-polar switching, index polarity aggravation, as well as alterations in episodic amplitude, episodic duration, and interepisode length. This approach has the potential to capture a broader, more fine-grained and clinically relevant picture of the process of aggravation of the bipolar cycle.
Language eng
Field of Research 111714 Mental Health
Socio Economic Objective 920410 Mental Health
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2010, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30035559

Document type: Journal Article
Collection: School of Medicine
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