Special review article
The potential utility of a staging model as a course specifier: A bipolar disorder perspective

https://doi.org/10.1016/j.jad.2007.03.007Get rights and content

Abstract

Staging models are widely used in clinical medicine, and offer an insight into the progressive nature of many disorders. In general, the earlier stages of illness may be associated with a better prognosis and a higher treatment response. Once chronicity is reached, more complex and invasive treatments may be required, and the utility of treatments may decline. There is evidence that treatment response is greatest in the early phases of the disorder. There is also a progressive social and psychological burden of ongoing illness. This is paralleled by the twin notions of neuroprotection, which is supported by increasing evidence that structural changes in the disorder may be progressive and reversible with algorithm appropriate treatment, and that of early intervention, which posits that the optimal window for intervention is early in the illness course. A staging model compliments existing and proposed classifications of bipolar disorder, adding a temporal dimension to a cross sectional view. It may inform treatment choice and prognosis, and could have utility as a course specifier.

Section snippets

Michael Berk MBBCh MMed(Psych) FF(Psych)SA FRANZCP PhD. Professor of Psychiatry in the Department of Clinical and Biomedical sciences at The University of Melbourne.

References (14)

There are more references available in the full text version of this article.

Cited by (135)

  • Older Age Bipolar Disorder

    2020, Clinics in Geriatric Medicine
View all citing articles on Scopus

Michael Berk MBBCh MMed(Psych) FF(Psych)SA FRANZCP PhD. Professor of Psychiatry in the Department of Clinical and Biomedical sciences at The University of Melbourne.

Karen Hallam BBSc(Hons) PhD. Research Fellow in the Department of Psychiatry at the University of Melbourne.

Patrick McGorry MBBS MD PhD FRCP FRANZCP. Professor of Psychiatry, Clinical and Research Director at O RYGEN Research Centre.

Declaration of interest: Professors Berk and McGorry have received research funding and/or program support from pharmaceutical companies that manufacture medications for the treatment of Bipolar Disorder. These include recent research grants from AstraZeneca, and Lilly.

View full text