Areas of controversy in neuroprogression in bipolar disorder.

Passos, I C, Mwangi, B, Vieta, E, Berk, M and Kapczinski, F 2016, Areas of controversy in neuroprogression in bipolar disorder., Acta psychiatrica scandinavica, vol. 134, no. 2, pp. 91-103, doi: 10.1111/acps.12581.

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Title Areas of controversy in neuroprogression in bipolar disorder.
Author(s) Passos, I C
Mwangi, B
Vieta, E
Berk, MORCID iD for Berk, M
Kapczinski, F
Journal name Acta psychiatrica scandinavica
Volume number 134
Issue number 2
Start page 91
End page 103
Total pages 13
Publisher Wiley
Place of publication London, Eng.
Publication date 2016-08
ISSN 1600-0447
Keyword(s) bipolar disorder
functional impairment
machine learning
treatment refractoriness
Summary OBJECTIVE: We aimed to review clinical features and biological underpinnings related to neuroprogression in bipolar disorder (BD). Also, we discussed areas of controversy and future research in the field. METHOD: We systematically reviewed the extant literature pertaining to neuroprogression and BD by searching PubMed and EMBASE for articles published up to March 2016. RESULTS: A total of 114 studies were included. Neuroimaging and clinical evidence from cross-sectional and longitudinal studies show that a subset of patients with BD presents a neuroprogressive course with brain changes and unfavorable outcomes. Risk factors associated with these unfavorable outcomes are number of mood episodes, early trauma, and psychiatric and clinical comorbidity. CONCLUSION: Illness trajectories are largely variable, and illness progression is not a general rule in BD. The number of manic episodes seems to be the clinical marker more robustly associated with neuroprogression in BD. However, the majority of the evidence came from cross-sectional studies that are prone to bias. Longitudinal studies may help to identify signatures of neuroprogression and integrate findings from the field of neuroimaging, neurocognition, and biomarkers.
Language eng
DOI 10.1111/acps.12581
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Wiley
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