The clinical trajectory of emerging bipolar disorder among the high-risk offspring of bipolar parents: current understanding and future considerations

Duffy, A.; Vandeleur, C.; Heffer, N.; Preisig, M.

Abstract

Background
Relatively little is known about the onset of bipolar disorder, yet the early illness course is already associated with significant morbidity and mortality. Therefore, characterizing the bipolar illness trajectory is key to risk prediction and early intervention advancement.

Main body
In this narrative review, we discuss key findings from prospective longitudinal studies of the high-risk offspring of bipolar parents and related meta-analyses that inform us about the clinical trajectory of emerging bipolar disorder. Challenges such as phenotypic and etiologic heterogeneity and the non-specificity of early symptoms and syndromes are highlighted. Implications of the findings for both research and clinical practice are discussed.

Conclusion
Bipolar disorder in young people at familial risk does not typically onset with a hypomanic or manic episode. Rather the first activated episode is often preceded by years of impairing psychopathological states that vary over development and across emerging bipolar subtype. Taking heterogeneity into account and adopting a more comprehensive approach to diagnosis seems necessary to advance earlier identification and our understanding of the onset of bipolar disorder.

• Journal Article Type: Article
• Acceptance Date: Sep 25, 2017
• Online Publication Date: Nov 22, 2017
• Publication Date: 2017-12
• Deposit Date: Jan 10, 2025
• Publicly Available Date: Jan 10, 2025
• Journal: International Journal of Bipolar Disorders
• Electronic ISSN: 2194-7511
• Publisher: SpringerOpen
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 1
• Article Number: 37
• DOI: https://doi.org/10.1186/s40345-017-0106-4
• Public URL: https://uwe-repository.worktribe.com/output/13608317