Evidence and implications for early intervention in bipolar disorder Berk, Michael, Hallam, Karen, Mahli, Gin S., Henry, Lisa, Hasty, Melissa, Macneil, Craig, Yucel, Murat, Pantelis, Chris, Murphy, Brendan, Vieta, Eduard, Dodd, Seetal and McGorry, Patrick D 2010, Evidence and implications for early intervention in bipolar disorder, Journal of mental health, vol. 19, no. 2, pp. 113-126, doi: 10.3109/09638230903469111. Attached Files Name Description MIMEType Size Downloads Title Evidence and implications for early intervention in bipolar disorder Author(s) Berk, Michael orcid.org/0000-0002-5554-6946 Hallam, Karen Mahli, Gin S. Henry, Lisa Hasty, Melissa Macneil, Craig Yucel, Murat Pantelis, Chris Murphy, Brendan Vieta, Eduard Dodd, Seetal orcid.org/0000-0002-7918-4636 McGorry, Patrick D Journal name Journal of mental health Volume number 19 Issue number 2 Start page 113 End page 126 Total pages 14 Publisher Routledge Place of publication Abingdon, England Publication date 2010-04 ISSN 0963-8237 1360-0567 Keyword(s) diagnosis neuroprotection mania depression bipolar disorders early intervention Summary Aims: To review the evidence that supports early intervention in the treatment of bipolar disorder. Background: Bipolar disorder is a pleomorphic condition, with varying manifestations that are determined by a number of complex factors including the ‘‘stage’’ of illness. It is consequently a notoriously difficult illness to diagnose and as a corollary is associated with lengthy delays in recognition and the initiation of suitable treatment. Methods: A literature search was conducted using MEDLINE augmented by a manual search. Results: Emerging neuroimaging data suggests that, in contrast to schizophrenia, where at the time of a first-episode of illness there is already discernible volume loss, in bipolar disorder, gross brain structure is relatively preserved, and it is only with recurrences that there is a sequential, but marked loss of brain volume. Recent evidence suggests that both pharmacotherapy and psychotherapy are more effective if instituted early in the course of bipolar disorder, and that with multiple episodes and disease progression there is a noticeable decline in treatment response. Conclusions: Such data supports the notion of clinical staging, and the tailored implementation of treatments according to the stage of illness. The progressive nature of bipolar disorder further supports the concept that the first episode is a period that requires energetic broad-based treatment, with the hope that this could alter the temporal trajectory of the illness. It also raises hope that prompt treatment may be neuroprotective and that this perhaps attenuates or even prevents the neurostructural and neurocognitive changes seen to emerge with chronicity. This highlights the need for early identification at a population level and the necessity of implementing treatments and services at a stage of the illness where prognosis is optimal. Language eng DOI 10.3109/09638230903469111 Field of Research 129999 Built Environment and Design not elsewhere classified Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences HERDC Research category C1.1 Refereed article in a scholarly journal Copyright notice ©2010, Informa UK Persistent URL http://hdl.handle.net/10536/DRO/DU:30035551 Document type: Journal Article Collections: Faculty of Health 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, 12:34:14 EST Fri, 07 Oct 2011, 11:52:16 EST Fri, 07 Oct 2011, 11:57:02 EST Fri, 07 Oct 2011, 11:58:23 EST Tue, 11 Oct 2011, 12:46:33 EST Tue, 11 Oct 2011, 12:48:12 EST Mon, 07 May 2012, 16:31:33 EST Mon, 16 Jun 2014, 18:22:55 EST Thu, 11 Dec 2014, 17:10:38 EST Filtered Full Citation counts:   Cited 76 times in TR Web of Science Cited 82 times in Scopus Search Google Scholar Access Statistics: 696 Abstract Views, 1 File Downloads  -  Detailed Statistics Created: Wed, 22 Jun 2011, 12:34:14 EST

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