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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. Attached Files Name Description MIMEType Size Downloads 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 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 Related Links Link Description Connect to published version (restricted access) Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Wed, 22 Jun 2011, 12:35:00 EST Mon, 10 Oct 2011, 07:32:57 EST Mon, 10 Oct 2011, 07:46:19 EST Mon, 10 Oct 2011, 07:48:15 EST Tue, 11 Oct 2011, 14:16:09 EST Mon, 16 Jun 2014, 18:23:24 EST Filtered Full Citation counts:   Cited 4 times in TR Web of Science Cited 5 times in Scopus Search Google Scholar Access Statistics: 53 Abstract Views, 1 File Downloads  -  Detailed Statistics Created: Wed, 22 Jun 2011, 12:35:00 EST

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