Table Of ContentNeuroprogression and
Staging in Bipolar Disorder
Neuroprogression
and Staging in
Bipolar Disorder
Edited by
Flavio Kapczinski
Professor of Psychiatry at Universidade Federal do Rio Grande
do Sul; Director of the Laboratory of Molecular Psychiatry,
Hospital de Clinicas de Porto Alegre; Visiting Professor of
Psychiatry at the Department of Psychiatry and Behavioral
Sciences at the University of Texas Health Science Center at
Houston.
Eduard Vieta
Professor of Psychiatry, Head of Department and Director of
the Bipolar Disorders Program, Hospital Clinic, University of
Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Pedro V. S. Magalhães
Professor of Psychiatry, Universidade Federal do Rio Grande
do Sul, Hospital de Clínicas de Porto Alegre, Brazil.
Michael Berk
NHMRC Senior Principal Research Fellow, Alfred Deakin
Professor of Psychiatry, School of Medicine, Deakin
University, Australia; Director, IMPACT Strategic Research
Centre (Innovation in Mental and Physical Health and Clinical
Treatment), Deakin University, Australia; Professorial Research
Fellow, The Florey Institute of Neuroscience and Mental
Health, Orygen, The National Centre of Excellence in Youth
Mental Health and the Department of Psychiatry, University
of Melbourne, Australia.
1
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Foreword
This beautiful book is the main delivery of the Task Force on Staging of
the International Society of Bipolar Disorders (ISBD). As the interna-
tionally recognized forum the mission of the ISBD is to foster ongoing
international collaboration on education and research with an objective
to advance the treatment of all aspects of bipolar disorders, resulting in
improvements in outcomes/quality of life for those with bipolar disor-
der and their significant others.
This aim is accomplished not only by holding every year the world-
wide biggest international conference on bipolar disorder, but also by
their many task forces: currently 8 completed and 12 ongoing. They rep-
resent the key research activities of the Society, each focusing on a sepa-
rate topic and aiming to examine and synthesize evidence usually in the
form of position statements and related publications.
The task force on Staging was started when - inspired by the early
work of McGorry et al. (2006) on staging in schizophrenia - the first
models for staging in bipolar disorder were developed by among others
Berk et al. (2007) and Kapczinski et al. (2009) who each had a different
approach, focusing on the development of and episodic course of the
illness (Berk et al.) versus on the progress in inter-episode functional
impairment (Kapczinski et al.). As with other Task Forces it was then
immediately recognized that not only a staging model would help to
better understand the development and consequences of the illness, but
also that both models might complement each other. Therefore, this
joint initiative to bring together both views in one Task Force was wel-
comed with great enthusiasm.
As past president of the ISBD we were involved in finding the right
place for the (shortened) report of the Task Force: the publication in
the Acta Psychiatrica Scandinavica (Kapczinski et al, 2014). And sub-
sequently, we were very pleased and proud about this book, a real proof
of international collaboration with 45 authors from 12 countries and
vi FOREWORD
3 continents. The book not only presents the different approaches as
indicated above, but also places the discussion in a broader perspective,
with chapters on research and (potential) clinical implications, includ-
ing cognition, neuroprogression, neuroprotection, biomarkers, imaging
and stage-specific differences/indications for treatment. I want to thank
all authors (see page ix–xii) and all members of the Task Force (see the
reference of Kapczinski et al, 2014 below) for their efforts!
Willem A. Nolen
President ISBD, 2012–2014
References
Berk M, Hallam KT, McGorry PD. (2007) The potential utility of a staging model as a
course specifier: a bipolar disorder perspective. J Affect Disord 100:279–281.
McGorry PD, Hickie IB, Yung AR, et al. (2006) Clinical staging of psychiatric disor-
ders: a heuristic framework for choosing earlier, safer and more effective interven-
tions. Aust NZ J Psychiat 40:616–622.
Kapczinski F, Dias VV, Kauer-Sant’Anna M, et al. (2009) Clinical implications of a
staging model for bipolar disorders. Expert Rev Neurother 9:957–966.
Kapczinski F, Magalhães PV, Balanzá-Martinez V, Dias VV, Frangou S, Gama CS,
Gonzalez-Pinto A, Grande I, Ha K, Kauer-Sant’Anna M, Kunz M, Kupka R,
Leboyer M, Lopez-Jaramillo C, Post RM, Rybakowski JK, Scott J, trejilevitch S,
Tohen M, Vazquez G, Yatham L, Vieta E, Berk M. (2014) Staging systems in bipo-
lar disorder: an International Society for Bipolar Disorders Task Force Report. Acta
Psychiatr Scand 130:354–363.
Contents
1 Clinical staging in bipolar disorder: a historical
perspective 1
Robert M. Post
2 Staging systems in bipolar disorder 17
Ralph W. Kupka, Manon H. J. Hillegers, and Jan Scott
3 Allostatic load and accelerated ageing in bipolar disorder 39
Iria Grande and Flavio Kapczinski
4 Neuroprogression and biological underpinnings of staging in
bipolar disorder 55
Gabriel R. Fries, Pedro V. S. Magalhães, Flavio Kapczinski, and
Michael Berk
5 Functioning and illness progression in bipolar disorder 81
Adriane R. Rosa, Clarissa S. Gama, and Eduard Vieta
6 Cognition and illness progression in bipolar disorder 99
Anabel Martinez-Aran, Caterina del Mar Bonnin, Carla Torrent,
Brisa Solé, Imma Torres, and Esther Jiménez
7 Social cognition and staging in bipolar disorder 115
Sergio Strejilevich and Diego Martino
8 Affective temperaments: potential latent stages of bipolar
disorders 127
Gustavo H. Vázquez and Xenia Gonda
9 Neuroimaging and illness progression 145
Benicio N. Frey, Luciano Minuzzi, Bartholomeus C.M. Haarman,
and Roberto B. Sassi
10 Biomarkers of illness progression in bipolar disorder 175
Aroldo A. Dargél and Marion Leboyer
11 Childhood adversity and illness progression in bipolar
disorder 197
Joana Bücker, Marcia Kauer-Sant’Anna, and Lakshmi N. Yatham
viii CONTENTS
12 Vascular and metabolic medical comorbidities and
neuroprogression in bipolar disorder 217
Anusha Baskaran, Benjamin I. Goldstein, and Roger McIntyre
13 Substance misuse in staging bipolar affective disorder 233
Romain Icick and Frank Bellivier
14 Excellent lithium responders, resilience, and staging in
bipolar disorder 249
Janusz K. Rybakowski
15 Staging and early intervention in bipolar disorder 269
Vicent Balanzá-Martínez, María Lacruz,
and Rafael Tabarés-Seisdedos
16 Pharmacological treatment of late-stage bipolar disorder 283
Aline André Rodrigues and Mauricio Kunz
17 Illness progression and psychosocial interventions in bipolar
disorder 295
María Reinares and Francesc Colom
18 Staging systems in bipolar disorder: current findings, future
directions, and implications for clinical practice 311
Flavio Kapczinski, Eduard Vieta, Pedro V. S. Magalhães,
and Michael Berk
Index 329
Contributors
Vicent Balanzá-Martínez, in Youth Mental Health and
Department of Medicine, the Department of Psychiatry,
University of Valencia, University of Melbourne, Australia
CIBERSAM, Valencia, Spain
Caterina del Mar Bonnin,
Anusha Baskaran, IDIBAPS, Bipolar Disorders
Centre for Neuroscience Studies, Program, Hospital Clinic,
Queen’s University; Providence University of Barcelona,
Care, Mental Health Services, CIBERSAM, Barcelona, Spain
Kingston, ON, Canada
Joana Bücker,
Frank Bellivier, Laboratory of Molecular
INSERM U797, Pole de Psychiatry and Bipolar Disorders
Psychiatrie, CHU de Créteil, Program and INCT Translational
Hôpital Henri Mondor & Paris 12 Medicine, Hospital de Clínicas
University, Créteil, France de Porto Alegre, Universidade
Federal do Rio Grande do Sul,
Michael Berk,
Porto Alegre, Brazil
NHMRC Senior Principal Research
Fellow, Alfred Deakin Professor
Francesc Colom,
of Psychiatry, School of Medicine,
IDIBAPS, Bipolar Disorders
Deakin University, Australia;
Program, Hospital Clinic,
Director, IMPACT Strategic
University of Barcelona,
Research Centre (Innovation
CIBERSAM, Barcelona, Spain
in Mental and Physical Health
and Clinical Treatment), Deakin Aroldo A. Dargél,
University, Australia; Professorial Laboratory of Molecular
Research Fellow, The Florey Psychiatry, INCT Translational
Institute of Neuroscience and Medicine, Hospital de Clínicas
Mental Health, Orygen, The de Porto Alegre (HCPA), Porto
National Centre of Excellence Alegre (RS), Brazil
