BACKGROUND: Considering results from the early recognition and intervention in psychosis, identification and treatment of individuals with at-risk states for the development of bipolar disorders (BD) could improve the course and severity of illness and prevent long-term consequences. Different approaches to define risk factors and groups have recently been published, data on treatment options are still missing. METHODS: Help-seeking persons at the early recognition center in Dresden, Germany, were assessed with a standardized diagnostic procedure including following risk factors for BD: familial risk, increasing mood swings, subsyndromal (hypo)manic symptoms, specific sleep and circadian rhythm disturbances, anxiety/fearfulness, affective disorder, decreased psychosocial functioning, increasing periodic substance use, and attention-deficit/hyperactivity disorder. Based on symptomatology and current and/or life-time psychiatric diagnosis, subjects with an at-risk state were offered individual treatment options. RESULTS: Out of 180 referred and screened persons, 29 (16%) met criteria for at-risk state for BD. Altogether, 27 (93%) at-risk individuals fulfilled criteria for a current and/or life-time mental illness other than BD; 14 (48%) had received pharmacological and/or psychotherapeutic treatment in the past. Treatments recommended included psychoeducation (100%), psychotherapy alone (62%), pharmacotherapy alone (17%), and psychotherapy+pharmacotherapy (14%). CONCLUSIONS: To identify at-risk states for BD, a multifactorial approach including all known risk markers should be used. As most at-risk patients meet criteria for other mental disorders, the short- and long-term impact of different treatment strategies on symptomatic, functional and diagnostic outcomes requires detailed investigation. LIMITATIONS: Small sample size of at-risk individuals, lack of sufficient prospective data and control groups.
BACKGROUND: Considering results from the early recognition and intervention in psychosis, identification and treatment of individuals with at-risk states for the development of bipolar disorders (BD) could improve the course and severity of illness and prevent long-term consequences. Different approaches to define risk factors and groups have recently been published, data on treatment options are still missing. METHODS: Help-seeking persons at the early recognition center in Dresden, Germany, were assessed with a standardized diagnostic procedure including following risk factors for BD: familial risk, increasing mood swings, subsyndromal (hypo)manic symptoms, specific sleep and circadian rhythm disturbances, anxiety/fearfulness, affective disorder, decreased psychosocial functioning, increasing periodic substance use, and attention-deficit/hyperactivity disorder. Based on symptomatology and current and/or life-time psychiatric diagnosis, subjects with an at-risk state were offered individual treatment options. RESULTS: Out of 180 referred and screened persons, 29 (16%) met criteria for at-risk state for BD. Altogether, 27 (93%) at-risk individuals fulfilled criteria for a current and/or life-time mental illness other than BD; 14 (48%) had received pharmacological and/or psychotherapeutic treatment in the past. Treatments recommended included psychoeducation (100%), psychotherapy alone (62%), pharmacotherapy alone (17%), and psychotherapy+pharmacotherapy (14%). CONCLUSIONS: To identify at-risk states for BD, a multifactorial approach including all known risk markers should be used. As most at-risk patients meet criteria for other mental disorders, the short- and long-term impact of different treatment strategies on symptomatic, functional and diagnostic outcomes requires detailed investigation. LIMITATIONS: Small sample size of at-risk individuals, lack of sufficient prospective data and control groups.
Authors: M Bauer; T Banaschewski; A Heinz; I Kamp-Becker; A Meyer-Lindenberg; F Padberg; M A Rapp; R Rupprecht; F Schneider; T G Schulze; H-U Wittchen Journal: Nervenarzt Date: 2016-09 Impact factor: 1.214
Authors: Lee Fu-I; Wagner de S Gurgel; Sheila C Caetano; Rodrigo Machado-Vieira; Yuan P Wang Journal: Braz J Psychiatry Date: 2019-09-26 Impact factor: 2.697
Authors: Andrea Pfennig; Karolina Leopold; Julia Martini; Anne Boehme; Martin Lambert; Thomas Stamm; Felix Bermpohl; Andreas Reif; Sarah Kittel-Schneider; Georg Juckel; Andreas J Fallgatter; Tilo Kircher; Andreas Jansen; Steffi Pfeiffer; Christina Berndt; Maren Rottmann-Wolf; Cathrin Sauer; Philipp Ritter; Christoph U Correll; Andreas Bechdolf; Irina Falkenberg; Michael Bauer Journal: Int J Bipolar Disord Date: 2020-07-01
Authors: Julia Martini; Karolina Leopold; Steffi Pfeiffer; Christina Berndt; Anne Boehme; Veit Roessner; Paolo Fusar-Poli; Allan H Young; Christoph U Correll; Michael Bauer; Andrea Pfennig Journal: Int J Bipolar Disord Date: 2021-07-02
Authors: Silvia Biere; Thorsten M Kranz; Silke Matura; Kristiyana Petrova; Fabian Streit; Andreas G Chiocchetti; Oliver Grimm; Murielle Brum; Natalie Brunkhorst-Kanaan; Viola Oertel; Aliaksandr Malyshau; Andrea Pfennig; Michael Bauer; Thomas G Schulze; Sarah Kittel-Schneider; Andreas Reif Journal: Front Psychiatry Date: 2020-10-26 Impact factor: 4.157