Is there a clinical prodromal period for bipolar disorder?

Abstract

Bipolar disorder (BD) is a prevalent, chronic and heterogeneous psychiatric disorder. The diagnosis of BD, is often delayed and the development of the disorder is associated with suicidal behavior. Growing evidence from both preclinical and clinical literature, points to a clear need for improved early intervention in BD. Individuals who develop BD are often afflicted during their most vulnerable and formative years. A major factor contributing to the burden of disease is the substantial delay between the first experience of symptoms and the initiation of the treatment. Early stage or prodromal BD should be considered in clinical, neuropsychological and biological terms. Early interventions may prevent the development of the full disorder, or at least improve the outcome. The initial prodrome of BD is characterized by disregulation of mood and energy. Large scale longitudinal studies which have control groups are needed to validate these features and characterize their specificity and sensitivity.

Keywords

• bipolar disorder, prodromal period

İki uçlu bozuklukta klinik prodrom dönemi bulunur mu?

Öz

İki uçlu bozukluk (İUB), yaygın süreğen ve heterojen psikiyatrik bir bozukluktur. İUB tanısı çoğu kez gecikmekte ve hastalığın gelişimi suisidal davranışlar ile ilişkilendirilmektedir. Klinik ve preklinik literatürde artan sayıda kanıt, iki uçlu bozuklukta geliştirilmiş erken müdahaleye olan belirgin ihtiyacı göstermektedir. İUB, genellikle bireylerin en çok etkilenebileceği ve üretken oldukları yıllarda başlamaktadır. Bu hastalığın, ağırlığına katkıda bulunan en büyük etmenlerden birisi de belirtilerin ilk olarak yaşandığı zaman ile tedavi başlanmasına kadar olan geçen önemli gecikmedir. Erken evre veya prodromal İUB klinik, nöropsikolojik ve biyolojik açılardan göz önünde bulundurulmalıdır. Erken müdahaleler hastalığın tam anlamıyla gelişmesine engel olabilir ya da en azından sonuçların daha iyi olmasına yol açabilir. İki uçlu bozukluğun prodrom döneminin başlaması, duygudurum ve enerjinin regülasyon bozukluğu ile karakterizedir. Bu özelliklerin geçerli kılınması ve spesifitesi ile sensitivitesinin karakterize edilmesi için geniş ölçekli, kontrol grubuna sahip, uzunlamasına çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• iki uçlu bozukluk, prodrom dönemi

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