Translating the philosophy of early intervention to clinical and research practice in bipolar disorders: Looking for a haystack!

Presentation First Author: 
Jan Scott

The clinical and research models promoted by the 'early intervention movement have transformed strategic approaches to the early stages of psychosis. This talk will explore whether this approach can be utilized in mood disorders in general, and in bipolar disorders in particular. First, it will briefly give an overview of findings from four studies (a) a systematic review of pre-pubertal bipolar disorders; (b) a systematic review of risk syndromes for early onset bipolar disorders; (c) a systematic review of duration of untreated bipolar disorder and (d) an evidence map of current psychological therapies targeting the critical period- ie at risk syndromes and the earliest stages of bipolar disorders. The presentation will highlight the problems of direct translation of these established approaches to affective states. For example, if depression a non-specific prodrome for many disorders, is the DUI for bipolar disorders defined by the onset of depression or mania? Ca! n staging models be applied to bipolar disorders? The presentation will explore the extent to which trans- diagnostic symptoms have been misunderstood or misintepreted (eg leading to an 'epidemic in the diagnosis of juvenile onset bipolar disorders in some countries...). It will be argued that greater attention to trans- diagnostic mechanisms and shared developmental processes such as coping response styles may better define individuals at risk of transition to severe mental disorders, and may help define some differences in illness trajectories. The pros and cons of these approaches in research and the opportunities for multi-system interventions will also be discussed.

Conference Name: 
Presentation Date: 
January, 2015
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