ReviewFrontiers in psychiatry2020
Depression Preceding Diagnosis of Bipolar Disorder.
Review in Frontiers in psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Emotion dysregulation in bipolar disorder compared to other mental illnesses: a systematic review and meta-analysis.Psychological medicine · 2023Pooled it
- Factors Predisposing to the Onset of Bipolar Disorder: A 30-Year Longitudinal Study.Bipolar disorders · 2025Trial
- Cross-Sectional and Longitudinal Comparison of Commonly Used Screening Tools for Bipolar Disorders.Bipolar disorders · 2026Article
- Patterns of psychotropic drug dispensation in Portugal amidst the COVID-19 pandemic and beyond.Scientific reports · 2026Article
- Are Differences in Social Drive in Childhood and Adolescence Diagnosis Specific? A Multimeasurement Subtyping Approach.JAACAP open · 2026Article
- Revisiting the prevalence of bipolar disorder: implications of a broader spectrum model.Frontiers in psychiatry · 2026Review
- Antidepressant treatment and risk of subsequent bipolar disorder in adolescents with unipolar depression.BMJ mental health · 2025Article
- Genistein Exerts Neuroprotective Effects in an Ouabain-Induced Model of Bipolar Disorder: Behavioral and Molecular Insights.Neurochemical research · 2025Article
- An Integrated Treatment Approach for Bipolar II Disorder: A Clinical Case Study.Journal of clinical medicine · 2025Article
- Ignoring atypical symptoms of depression in common scales.World journal of psychiatry · 2025Article
- Left Ventrolateral Prefrontal Cortical Activity During Reward Expectancy and Mania Risk.JAMA psychiatry · 2025Article
- Outpatient Management of Bipolar Disorder in Older Adults.Current psychiatry reports · 2025Review
- Lifetime Prevalence of Recurrent and Persistent Depression: A Scoping Review of Epidemiological Studies.Clinical practice and epidemiology in mental health : CP & EMH · 2025Review
- Mortality in patients with major depressive disorder: A nationwide population-based cohort study with 11-year follow-up.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
- Factors Associated with the Development of Depression and the Influence of Obesity on Depressive Disorders: A Narrative Review.Biomedicines · 2024Review
- Distinguishing Affective Temperament Profiles in Major Depressive Disorder and Bipolar Disorder Through the Short Version of TEMPS-A: Cross-Sectional Study Using Latent Profile Analysis.Psychiatry investigation · 2024Article
- Identifying misdiagnosed bipolar disorder using support vector machine: feature selection based on fMRI of follow-up confirmed affective disorders.Translational psychiatry · 2024Article
- Comparison of Immune and Systemic Inflammation Parameters in Patients with a Depressive Episode in Bipolar Disorder and Major Depressive Disorder: A Scoping Review.Consortium psychiatricum · 2024Review
- Serum neuroactive metabolites of the tryptophan pathway in patients with acute phase of affective disorders.Frontiers in psychiatry · 2024Article
- Developmental Trajectory of Body Weight in Youths at Risk for Major Mood Disorders.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This paper focuses on depression that precedes an onset of manifest bipolar disorder as early stage bipolar disorder. First, we review how to pragmatically identify the clinical characteristics of patients presenting with an episode of depression who subsequently go on to develop episodes of mania or hypomania. The existing literature shows a strong consensus: accurate identification of depression with early onset and recurrent course with multiple episodes, subthreshold hypomanic and/or mixed symptoms, and family history of bipolar disorder or completed suicide have been shown by multiple authors as signs pointing to bipolar diagnosis. This contrasts with relatively limited information available to guide management of such "pre-bipolar" (pre-declared bipolar) patients, especially those in the adult age range. Default assumption of unipolar depression at this stage carries significant risk. Antidepressants are still the most common pharmacological treatment used, but clinicians need to be aware of their potential harm. In some patients with unrecognized bipolar depression, antidepressants can not only produce switch to (hypo)mania, but also mixed symptoms, or worsening of depression with an increased risk of suicide. We review pragmatic management strategies in the literature beyond clinical guidelines that can be considered for this at-risk group encompassing the more recent child and adolescent literature. In the future, genetic research could make the early identification of bipolar depression easier by generating informative markers and polygenic risk scores.
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