{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:12:40Z","timestamp":1790734360953,"version":"4.1.0"},"reference-count":86,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,10,16]],"date-time":"2013-10-16T00:00:00Z","timestamp":1381881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Early intervention and preventive strategies have become major targets of research and service development in psychiatry over the last few years. Compared to schizophrenia, bipolar disorder (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>) has received limited attention in this regard. In this paper, we review the available literature in order to explore the public health significance of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> and the extent to which this may justify the development of early intervention strategies for this disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The main computerized psychiatric literature databases were accessed. This included Medline and PsychInfo, using the following keywords: <jats:italic>bipolar<\/jats:italic>,<jats:italic> early intervention<\/jats:italic>,<jats:italic> staging model<\/jats:italic>,<jats:italic> burden<\/jats:italic>,<jats:italic> caregiver<\/jats:italic>,<jats:italic> public health<\/jats:italic>, and <jats:italic>manic depression<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> is often recurrent and has an impact that goes well beyond symptomatic pathology. The burden it incurs is linked not only to its cardinal clinical features, but also to cognitive dysfunction, poor functional outcome, poor physical health, high rate of comorbidities, and suicide. At a societal level, <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> induces enormous direct and indirect costs and has a major impact on caregivers. The available literature reveals a usually long delay between illness onset and the start of treatment, and the absence of specific guidelines for the treatment of the early phase of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Considering the major impact of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> on patients and society, there is an urgent need for the development of early intervention strategies aimed at earlier detection and more specific treatment of the early phase of the disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12137","type":"journal-article","created":{"date-parts":[[2013,10,16]],"date-time":"2013-10-16T08:52:50Z","timestamp":1381913570000},"page":"548-556","source":"Crossref","is-referenced-by-count":76,"title":["Public health significance of bipolar disorder: implications for early intervention and prevention"],"prefix":"10.1111","volume":"16","author":[{"given":"Philippe","family":"Conus","sequence":"first","affiliation":[{"name":"Service de Psychiatrie G\u00e9n\u00e9rale D\u00e9partement Universitaire de Psychiatrie CHUV Lausanne University Clinique de Cery Prilly Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Macneil","sequence":"additional","affiliation":[{"name":"Orygen Youth Health and Research Centre Early Psychosis Prevention and Intervention Centre (EPPIC) Parkville Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick D","family":"McGorry","sequence":"additional","affiliation":[{"name":"Orygen Youth Health and Research Centre Early Psychosis Prevention and Intervention Centre (EPPIC) Parkville Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.11.007"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03450190043026"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.12"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3182531f17"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1399-5618.2003.00073.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-192104000-00057"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2010.531828"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2001.00059.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60512-6"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1614.2002.00994.x"},{"key":"e_1_2_7_13_1","first-page":"652","article-title":"Symptoms and functioning of patients with bipolar disorder six months after hospitalisation","volume":"39","author":"Dion GL","year":"1988","journal-title":"Hosp Community Psychiatry"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2006.00315.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000255957"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1399-5618.2003.00091.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.59.6.530"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000012361"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0920-9964(91)90069-4"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2008.00640.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0712"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v58n0105"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.175.3.246"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.9.1.81"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(90)90416-Y"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(98)00336-9"},{"key":"e_1_2_7_27_1","first-page":"120","article-title":"Cognitive deficits, psychopathology, and psychosocial functioning in bipolar mood disorder","volume":"11","author":"Atre\u2010Vaidya N","year":"1998","journal-title":"Neuropsychiatry Neuropsychol Behav Neurol"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00716.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2011.00928.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2012.01011.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710001613"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2012.01004.x"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3928\/0048-5713-19960702-07"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.06.014"},{"issue":"25","key":"e_1_2_7_35_1","first-page":"31","article-title":"Idetifying and managing suicide risk in bipolar patients","volume":"62","author":"Oquendo MA","year":"2001","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.9.1.109"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1943-278X.2010.00007.x"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07450-0"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.08m04586yel"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2011.00932.x"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.04.012"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12050620"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2011.06.008"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1979.01780120025002"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079903125002801"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2011.00969.x"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(98)00142-6"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200119050-00004"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696990903475833"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.180.3.227"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.04.020"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1939-0025.2010.01081.x"},{"key":"e_1_2_7_53_1","volume-title":"Manic\u2010depressive Illness","author":"Goodwin FK","year":"1990"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2003.02057.x"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2007.01.027"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(87)90009-7"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-5618.2003.00051.x"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(94)90104-X"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700003147"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00319.x"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(00)00310-4"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199802000-00009"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/6.4.579"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1985.tb10510.x"},{"key":"e_1_2_7_65_1","first-page":"47","article-title":"Prediction of relapse in recurrent affective disorder","volume":"16","author":"Zis AP","year":"1980","journal-title":"Psychopharmacol Bull"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v63n1105"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370204700202"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-5618.2003.00030.x"},{"key":"e_1_2_7_69_1","doi-asserted-by":"crossref","first-page":"556","DOI":"10.2165\/11535200-000000000-00000","article-title":"The cost of relapse for patients with a manic\/mixed episode of bipolar disorder in the EMBLEM study","volume":"28","author":"Hong J","year":"2010","journal-title":"Pharmacoeconomics"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.149.8.999"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2011.00889.x"},{"key":"e_1_2_7_72_1","first-page":"36","article-title":"From neuroprogression to neuroprotection: implications for clinical care","volume":"193","author":"Berk M","year":"2010","journal-title":"Med J Aust"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1614.2006.01860.x"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370104600710"},{"key":"e_1_2_7_75_1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1192\/S0007125000297687","article-title":"Pharmacotherapy of first\u2010episode schizophrenia","volume":"172","author":"Remington G","year":"1998","journal-title":"Brit J Psychiatry"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2011.00336.x"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2011.00273.x"},{"key":"e_1_2_7_78_1","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1176\/ajp.156.8.1264","article-title":"Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in mania","volume":"156","author":"Swann AC","year":"1999","journal-title":"Am J Psychiatry"},{"key":"e_1_2_7_79_1","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/j.1440-1614.2006.01775.x","article-title":"Pharmacological treatment in the early phase of bipolar disorders: what stage are we at?","volume":"40","author":"Conus P","year":"2006","journal-title":"Aust N Z J Psychiatry"},{"key":"e_1_2_7_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00724.x"},{"key":"e_1_2_7_81_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.188.4.313"},{"issue":"1","key":"e_1_2_7_82_1","first-page":"20","article-title":"Long\u2010term follow\u2010up of psychotherapies in bipolar disorder","volume":"10","author":"Colom F","year":"2008","journal-title":"Bipolar Disord"},{"key":"e_1_2_7_83_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.584"},{"key":"e_1_2_7_84_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2008.00610.x"},{"key":"e_1_2_7_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.12.021"},{"key":"e_1_2_7_86_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2007.00487.x"},{"key":"e_1_2_7_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.06.016"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbdi.12137","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.12137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T15:58:53Z","timestamp":1694447933000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bdi.12137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,16]]},"references-count":86,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1111\/bdi.12137"],"URL":"https:\/\/doi.org\/10.1111\/bdi.12137","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,16]]}}}