Evidence map›Paper›PMID 34174130›Full record

ReviewBipolar disorders2021

Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force.

Ralph Kupka, Anne Duffy, Jan Scott, Jorge Almeida, Vicent Balanzá-Martínez, Boris Birmaher, David J Bond, Elisa Brietzke, Ines Chendo, Benicio N Frey and 16 more

Abstract readReviewConsensus Statement
In one paragraph

Review in Bipolar disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Biomarkers of neuroprogression and late staging in bipolar disorder: A systematic review.The Australian and New Zealand journal of psychiatry · 2023
    Pooled it
  2. Review
  3. Article
  4. Clinical staging and profiling of affective disorders.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Review
  5. Addressing the unmet needs of bipolar disorder in Australia and beyond.The Australian and New Zealand journal of psychiatry · 2025
    Article
  6. Article
  7. Article
  8. Article
  9. Transdiagnostic Clinical Staging in Youth Mental Health: A primer for clinical practice.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2025
    Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022
    Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Ralph KupkaDepartment of Psychiatry, Amsterdam Public Mental Health Research Insitute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.ORCID 0000-0002-1662-7436
Anne DuffyDepartment of Psychiatry, Division of Student Mental Health, Queen's University, Cote Sharp Student Wellness Centre, Kingston, ON, Canada.ORCID 0000-0002-5895-075X
Jan ScottInstitute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-7203-8601
Jorge AlmeidaDepartment of Psychiatry and Behavior Sciences, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
Vicent Balanzá-MartínezTeaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain.
Boris BirmaherUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USA.
David J BondDepartment of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA.ORCID 0000-0002-8713-7311
Elisa BrietzkeDepartment of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada.ORCID 0000-0003-2697-1342
Ines ChendoPsychiatry Department, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal.
Benicio N FreyDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-8267-943X
Iria GrandeBarcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Danella HafemanDepartment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.ORCID 0000-0001-8312-3513
Tomas HajekDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.ORCID 0000-0003-0281-8458
Manon HillegersDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Marcia Kauer-Sant'AnnaDepartment of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS, Hospital de Clínicas de Porto Alegre (HCPA, Porto Alegre, Brazil.
Rodrigo B MansurMood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
Afra van der MarktDepartment of Psychiatry, Amsterdam Public Mental Health Research Insitute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.ORCID 0000-0002-4022-9438
Robert PostGeorge Washington University School of Medicine, Washington, DC, USA.ORCID 0000-0002-4246-524X
Mauricio TohenDepartment of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.ORCID 0000-0001-8049-4351
Hailey TremainCentre for Mental Health, Faculty of Health Arts and Design, Swinburne University, Melbourne, Vic, Australia.ORCID 0000-0001-6304-1940
Gustavo VazquezDepartment of Psychiatry, Queen's University, Kingston, ON, Canada.
Eduard VietaHospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.ORCID 0000-0002-0548-0053
Lakshmi N YathamDepartment of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Michael BerkIMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Vic, Australia.
Martin AldaDepartment of Psychiatry, Mood Disorders Clinic, Dalhousie University, Halifax, NC, Canada.ORCID 0000-0001-9544-3944
Flávio KapczinskiSt. Joseph's Healthcare Hamilton McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-8738-856X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesClinical staging is widely used in medicine to map disease progression, inform prognosis, and guide treatment decisions; in psychiatry, however, staging remains a hypothetical construct. To facilitate future research in bipolar disorders (BD), a well-defined nomenclature is needed, especially since diagnosis is often imprecise with blurred boundaries, and a full understanding of pathophysiology is lacking.

methodsUnder the auspices of the International Society of Bipolar Disorders, a Task Force of international experts was convened to review, discuss, and integrate findings from the scientific literature relevant to the development of a consensus staging model and standardize a terminology that could be used to advance future research including staging of BD and related disorders.

resultsConsensus opinion and areas of uncertainty or difference were identified in regard to terms referring to staging as it may apply to BD, to at-risk status and subthreshold stages, and to various clinical stages of BD as it is currently diagnosed.

conclusionThe use of a standardized nomenclature about the clinical stages of BD will facilitate communication about research on clinical and pathological components of this heterogeneous group of disorders. The concepts presented are based on current evidence, but the template provided allows for further refinements as etiological advances come to light.

Indexed as

Bipolar DisorderAdvisory CommitteesDisease ProgressionHumansPrognosisbipolar disordersclinical stagingnomenclature

Identifiers

PMID34174130
PMCPMC9290926

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.