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Early intervention in bipolar disorders : clinical, biochemical and neuroimaging imperatives

journal contribution
posted on 2009-04-01, 00:00 authored by Michael BerkMichael Berk, G Malhi, Karen Hallam, C Gama, Seetal DoddSeetal Dodd, A Andreazza, B Frey, F Kapczinski
In the absence of clear targets for primary prevention of many psychiatric illnesses, secondary prevention becomes the most feasible therapeutic target, and is best encompassed by the concept of early intervention. This construct encompasses the goals of minimising diagnostic delay and the prompt initiation of clinically appropriate therapy. This paper develops the rationale for early intervention in bipolar disorder. Three interrelated themes are discussed; the clinical data supporting the value of prompt diagnosis and treatment in bipolar disorder, the putative biochemical mechanisms underlying the pathophysiological processes, and the parallel concept of neuroprotection, and the developing neuroimaging data that supports early intervention. Early initiation of appropriate therapy may potentially facilitate improved clinical outcomes, and further might allow the secondary prevention of the sequelae of untreated illness, which include the deleterious impact on family relationships, psychosexual and vocational development, identity and self-concept and self-stigma.

History

Journal

Journal of affective disorders

Volume

114

Pagination

1 - 13

Publisher

Elsevier BV

Location

Amsterdam, The Netherlands

ISSN

0165-0327

eISSN

1573-2517

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2009, Elsevier B.V.