{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:09:29Z","timestamp":1785409769024,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,12,12]],"date-time":"2018-12-12T00:00:00Z","timestamp":1544572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Bipolar disorder has a wide range of clinical manifestations which may progress over time. The aim of this study was to test the applicability of a clinical staging model for bipolar disorder and to gain insight into the nature of the variables influencing progression through consecutive stages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using retrospectively reported longitudinal life chart data of 99 subjects from the Stanley Foundation Bipolar Network Naturalistic Follow\u2010up Study, the occurrence, duration and timely sequence of stages 2\u20104 were determined per month. A multi\u2010state model was used to calculate progression rates and identify determinants of illness progression. Stages 0, 1 and several other variables were added to the multi\u2010state model to determine their influence on the progression rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five years after onset of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> (stage 2), 72% reached stage 3 (recurrent episodes) and 21% had reached stage 4 (continuous episodes), of whom 8% recovered back to stage 3. The progression from stage 2 to 3 was increased by a biphasic onset for both the depression\u2010mania and the mania\u2010depression course and by male sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Staging is a useful model to determine illness progression in longitudinal life chart data. Variables influencing transition rates were successfully identified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12727","type":"journal-article","created":{"date-parts":[[2018,11,17]],"date-time":"2018-11-17T13:33:41Z","timestamp":1542461621000},"page":"228-234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Testing a clinical staging model for bipolar disorder using longitudinal life chart data"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4022-9438","authenticated-orcid":false,"given":"Afra","family":"van der Markt","sequence":"first","affiliation":[{"name":"Department of Psychiatry Amsterdam Public Health Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula MH","family":"Klumpers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stasja","family":"Draisma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam Public Health Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1964-0318","authenticated-orcid":false,"given":"Annemiek","family":"Dols","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam Public Health Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Department of Psychiatry Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem A","family":"Nolen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University Medical Center University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4246-524X","authenticated-orcid":false,"given":"Robert M","family":"Post","sequence":"additional","affiliation":[{"name":"Bipolar Collaborative Network Bethesda Maryland"},{"name":"Department of Psychiatry and Behavioral Sciences George Washington University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori L","family":"Altshuler","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine University of California Los Angeles California"},{"name":"Department of Psychiatry VA Greater Los Angeles Healthcare System West Los Angeles Healthcare Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"Frye","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-8979","authenticated-orcid":false,"given":"Heinz","family":"Grunze","sequence":"additional","affiliation":[{"name":"Klinikum am Weissenhof Weinsberg Germany &amp; Paracelsus Medical University Nuremberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Paul E","family":"Keck","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine Cincinnati Ohio"},{"name":"Lindner Center of HOPE Mason Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L","family":"McElroy","sequence":"additional","affiliation":[{"name":"Lindner Center of HOPE Mason Ohio"},{"name":"Biological Psychiatry Program University of Cincinnati Medical College Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Suppes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Palo Alto California"},{"name":"V.A. 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