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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?
journal contribution
posted on 2010-08-01, 00:00 authored by Michael BerkMichael Berk, F Ng, Seetal DoddSeetal Dodd, J Goldberg, G MalhiThe 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.
History
Journal
Psychiatry and clinical neurosciencesVolume
64Issue
4Pagination
367 - 371Publisher
Wiley - Blackwell Publishing AsiaLocation
Richmond, Vic.Publisher DOI
ISSN
1323-1316eISSN
1440-1819Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2010, The AuthorsUsage metrics
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