{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T13:23:48Z","timestamp":1793021028287,"version":"4.5.0"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,8,20]],"date-time":"2012-08-20T00:00:00Z","timestamp":1345420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p><jats:bold>Objective:\u2002<\/jats:bold> Duration of untreated illness represents a potentially modifiable component of any diagnosis\u2010treatment pathway. In bipolar disorder (BD), this concept has rarely been systematically defined or not been applied to large clinically representative samples.<\/jats:p><jats:p><jats:bold>Method:\u2002<\/jats:bold> In a well\u2010characterized sample of 501 patients with BD, we estimated the duration of untreated bipolar disorder (DUB: the interval between the first major mood episode and first treatment with a mood stabilizer). Associations between DUB and clinical onset and the temporal sequence of key clinical milestones were examined.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> The mean DUB was 9.6\u2003years (SD 9.7; median 6). The median DUB for those with a hypomanic onset (14.5\u2003years) exceeded that for depressive (13\u2003years) and manic onset (8\u2003years). Early onset BD cases have the longest DUB (<jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.0001). An extended DUB was associated with more mood episodes (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0001), more suicidal behaviour (<jats:italic>P<\/jats:italic>\u2003=\u20030.0003) and a trend towards greater lifetime mood instability (e.g. rapid cycling, possible antidepressant\u2010induced mania).<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Duration of untreated bipolar disorder (DUB) will only be significantly reduced by more aggressive case finding strategies. Reliable diagnosis (especially for BD\u2010II) and\/or instigation of recommended treatments is currently delayed by insufficient awareness of the early, polymorphous presentations of BD, lack of systematic screening and\/or failure to follow established guidelines.<\/jats:p>","DOI":"10.1111\/j.1600-0447.2012.01917.x","type":"journal-article","created":{"date-parts":[[2012,8,20]],"date-time":"2012-08-20T11:25:44Z","timestamp":1345461944000},"page":"136-144","source":"Crossref","is-referenced-by-count":235,"title":["Duration of untreated bipolar disorder: missed opportunities on the long road to optimal treatment"],"prefix":"10.1111","volume":"127","author":[{"given":"N.","family":"Drancourt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Etain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Lajnef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Raust","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Cochet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Mathieu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Gard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"MBailara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Zanouy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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