Is there a clinical prodromal period for bipolar disorder?

Öz

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.

Anahtar Kelimeler

• 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

Kaynakça

1. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64: 543–52.
2. Waraich P, Goldner EM, Somers JM, Hsu L. Prevalence and incidence studies of mood disorders: a systematic review of the literature Can J Psychiatry. 2004;49:124–38.
3. Homish GG, Marshall D, Dubovsky SL, Leonard K. Predictors of later bipolar disorders in patients with subthreshold symptoms. J Affect Disord. 2012;144:129-33.
4. Altınbaş K, Darçın AE, Gülöksüz S, Oral TE. İki uçlu bozuklukta metabolik sendrom yaygınlığının mevsimsel değişimi. Journal of Mood disorders. 2012;2: 51-7.
5. Savaş HA, Unal A, Vırıt O. Treatment adherence in bipolar disorder. Journal of Mood disorders. 2011;1:95-102.
6. Toprak E, Yavuz B. Anxiety disorders comorbidity in bipolar disorder patients and quality of life. Journal of Mood disorders. 2011;1:55-62.
7. Kalenderoğlu A, Savaş AH, Gergerlioğlu HS, Başaralı K, Yumru M, Selek S, Büyükbaş S, Ergene N. Bipolar hastalarda serum ghrelin seviyeleri ve metabolik sendrom arasındaki ilişki. Nöropsikiyatri Arşivi. 2010;47:328-32.
8. Annagür BB, Zincir SB, Bez Y, İnanlı I, Şahingöz M, Ateş N, Alpak G. İki Uçlu Bozukluğu Olan Kadınların Sosyal ve Üreme Yaşamları: Türkiye’den Tanımlayıcı Bir Çalışma. Journal of Mood Disorders. 2013;3:11-6.

9. Osby U, Brandt L, Correia N, Ekbom A, Sparen P. Excess mortality in bipolar and unipolar disorder in Sweden.Arch Gen Psychiatry. 2001;58:844-50.
10. Dutta R, Boydell J, Kennedy N, Van Os J, Fearon P, Murray RM.Suicide and other causes of mortality in bipolar disorder: a longitudinal study. Psychol Med. 2007;37:839-47.
11. Baldessarini RJ, Bolzani L, Cruz N, Jones PB, Lai M, Lepri B, Perez J, Salvatore P, Tohen M, Tondo L, Vieta E. Onset-age of bipolar disorders at six international sites. J Affect Disord. 2010;121:143-6. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic –depressive association 2000 survey of individuals with bipolar disorder. J. Clin. Psychiatry. 2003;64:161-74.
12. Suppes T, Leverich GS, Keck PE, Nolen WA, Denicoff KD, McElroy SL, Rush AJ, Kupka R, Frye MA, Bickel M, Post RM. The stanley foundation bipolar treatment outcome network. II. demographics and illness characteristics of the first 261 patients. J Affect Disord. 2001;67:45-59.
13. Franchini L, Zanardi R, Smeraldi E, Gasperini M. Early onset of lithium prophylaxis as a predictor of good long-term outcome. Eur Arch Psychiatry Clin. Neurosci. 1999;249:227-30 .
14. Baldessarini RJ, Tondo L, Hennen J. Treatment –latency and previous episodes: relationships to pretreatment morbidity and response to maintenance treatment in bipolar I and II disorders . Bipolar Disord. 2003;5:167-79.
15. Swann AC, Bowden CL, Calabrase JR, Dilsaver SC, Morris DD. Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry 1999;156:1264-6.
16. Gazalle FK, Andreazza AC, Cereser KM, Hallal PC, Santin A, Kapczinski F. Clinical impact of late diagnose of bipolar disorder. J Affect Disord. 2005;86: 313-6.
17. Berk M, Brnabic A, Dodd S, Kelin K, Tohen M, Malhi GS, Berk L, Conus P, McGorry PD. Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention. Bipolar Disord. 2011;13:87-98.
18. Altshuller LL, Post RM, Leverich GS, Mikalauskas K, Rosoff A, Ackerman L. Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry. 1995;152:1130-8.
19. Leverich GS, Altshuler LL, Frye MA, Suppes T, McElroy SL, Keck PE Jr, Kupka RW, Denicoff KD, Nolen WA, Grunze H, Martinez MI, Post RM. Risk of switch in mood polarity to hypomania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. Am J Psychiatry. 2006;163:232-39.
20. Kochman FJ,Hantouche EG, Ferrrari P,Lancrenon S, Bayart D, Akiskal HS. Cyclothymic temperament as a prospective predictor of bipolarity and suicadility in children and adolescent with major depressive disorder. Journal of Affective Disorders. 2005;85:181-9.
21. Correl CU, Smith CW, Auther AM, McLaughlin D, Shah M, Foley C, Olsen R, Lencz T, Kane JM, Cornblatt BA. Predictors of remission, schizophrenia, and bipolar disorder in adolescent with brief psychotic disorder or psychotic disorder not otherwise specified considered at very high risk for schizophrenia. Journal of Child and Adolescent Psychopharmacology. 2008;18: 475-90.
22. Akiskal HS, Downs J, Jordan P, Watson S, Daugherty D, Pruitt DB. Affective disorders in referred children and younger siblings of manic-depressives. Mode of onset and prospective course. Archives of General Psychiatry. 1985;42: 996-1003.
23. Howes OD, Lim S, Theologos G, Yung AR, Goodwin GM, McGuire P. A comprehensive review and model of putative prodromal features of bipolar affective disorder. Psychol Med. 2011;41:1567-77.
24. Blechert J, Meyer TD. Are measures of hypomanic personality, impulsive nonconformity and rigidity predictors of bipolar symptoms? British Journal of Clinical Psychology 2005;44:15-27.
25. Angst J, Gamma A, Endrass J. Risk factors for the bipolar and depression spectra. Acta Psychiatrica Scandinavica. 2003;418:15-9.
26. Tijssen MJ, van Os J, Wittchen HU, Lieb R, Beesdo K, Mengelers R, Krabbendam L, Wichers M . Evidence that bipolar disorder is the poor outcome fraction of a common developmental phenotype: an 8-year cohort study in young people. Psychological Medicine. 2010;40:289-99.
27. Martin DJ, Smith DJ. Is there a clinical prodrome of bipolar disorder . Expert Rev. Neurother 2013;13:89-98.
28. Skjelstad DV, Malt UF, Holte A. Symptoms and signs of the initial prodrome of bipolar disorder: a systematic review. J Affect Disord. 2010;126:1-13.
29. Lichtenstein P, Yip H, Bjork C. Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study. Lancet. 2009;373:234-9.
30. Soares JC, Kochunov P, Monkul ES, Nicoletti MA, Brambilla P, Sassi RB, Mallinger AG, Frank E, Kupfer DJ, Lancaster J, Fox P. Structural brain changes in bipolar disorder using deformation field morpometry. Neuroreport. 2005;16:541-44.
31. Moorhead TW, McKirdy J, Sussmann JE, Hall J, Lawrie SM, Johnstone EC, McIntosh AM. Progressive gray matter loss in patients with bipolar disorder. Biol Psychiatry 2007;62:894-900.
32. Blumberg HP, Krystal JH, Bansal R, Martin A, Dziura J, Durkin K, Martin L, Gerard E, Charney DS, Peterson BS. Age, rapidcycling, and pharmacotherapy effects on ventral prefrontal cortex in bipolar disorder: a cross-sectional study. Biol Psychiatry. 2006;59:611-8.
33. Atagün Mİ, Cevahirli ES, Kara T, Tabakçı S, Balaban ÖD, Yeşilbaş D. Distinct clinical characteristics of familial and solitary patients with bipolar disorder. Journal of Mood disorders. 2011;1:110-7.
34. Berk M, Conus P, Lucas N, Hallam K, Malhi GS, Dodd S, Yatham LN, Yung A, McGorry P. Setting the stage, from prodrome to treatmen t resistance in bipolar disorder. Bipolar Disord. 2007;9:671-8.
35. Elanjithara T, Frangou S, McGuire P. Treatment of the early stages of bipolar disorder. Adv Psych Treat. 2011;17:283-91.
36. Ritter PS, Marx C, Bauer M, Leopold K, Pfennig A. The role of disturbed sleep in the early recognition of bipolar disorder: a systematic review. Bipolar Disord. 2011. 13:227-37.
37. Angst J. The bipolar spectrum. Br J Psychiatry. 2007;190:189-91.
38. Correll CU, Penzner JB, Frederickson AM, Richter JJ, Auther AM, Smith CW, Kane JM, Cornblatt BA. Differentiation in the preonset phases of schizophrenia and mood disorders: evidence in support of bipolar mania prodrome. Schizophr Bull. 2007;33:703-14.
39. Conus P, Ward J, Lucas N, Cotton S, Yung AR, Berk M, McGorry PD. Characterisation of the prodrome to a first episode of psychotic mania: results of a retrospective study. Journal Of Affective Disorders. 2010;124:341-5.
40. Egeland JA, Hostetter AM, Pauls DL, Sussex JN. Prodromal symptoms before onset of manic-depressive disorder suggested by first hospital admission histories. J Am Acad Child Adolesc Psych. 2000;39:1245-52.
41. Egeland JA, Blumenthal RL, Nee J, Sharpe L, Endicott J. Reliability and relationship of various ages of onset criteria. J Affect Disord. 1987;12:159-65.
42. Berk M, Dodd S, Callaly P, Berk L, Fitzgerald P, de Castella AR, Filia S, Filia K, Tahtalian S, Biffin F, Kelin K, Smith M, Montgomery W, Kulkarni J. History of illness prior to a diagnosis of bipolar disorder or schizoffective disorder. J Affect Disord. 2007;103:181-6.
43. Rucklidge JJ. Retrospective parent report of psychiatric histories: do checklists reveal spesific prodromal indicators for postpubertalonset pediatric bipolar disorder? Bipolar Disorders. 2008;10:56-66. Findling RL, Youngstrom EA, McNamara NK, Stansbrey RJ, Demeter CA, Bedoya D, Kahana SY, Calabrese JR. Early symptoms of mania and the role of parental risk. Bipolar Disorders. 2005;7:623-634.
44. Jones SH, Tai S,Evershed K, Knowles R, Bentall R. Early detection of bipolar disorder: a pilot familial high-risk study of parents with bipolar disorder and their adolescent children. Bipolar Disorders 2006;8: 362-72.
45. Alataş G, Kurt E, Alataş ET, Bilgiç V, Karatepe HT. Psychoeducation in Mood Disorders. Düşünen Adam. 2007;20:196-205.
46. Olvet DM, Stearns WH, Laughlin DM, Auther AM, Correl CU, Cornblatt BA. Comparing Clinical and neurocognitive features of the schizophrenia prodrome to the bipolar prodrome. Schizophr Res. 2010;123:56-93.
47. Kessing LV, Hansen HV, Christensen EM, Dam H, Gluud C, Wetterslev J. The effects of centralized and specialised combined pharmacological and psychological intervention compared with decentralised and non-specialised treatment in the early course of severe unipolar and bipolar affective disorders-design of two randomised clinical trials. Trials. 2011;12:32.
48. Tijssen MJ, van Os J, Wittchen HU, Lieb R, Beesdo K, Mengelers R, Wichers M. Prediction of transition from common adolescent bipolar experiences to bipolar disorder:10-year study. British Journal of Psychiatry. 2010;196:102-8.