Instruments that prospectively predict bipolar disorder - A systematic review.

Area of Science:

• Psychiatry and Mental Health
• Clinical Psychology
• Neuroscience

Background:

• Early identification of Bipolar Disorder (BD) is vital for developing preventative interventions.
• Reliable and valid instruments are needed to detect earlier stages of BD before the first manic episode.
• Current research aims to find tools for early intervention (EI) settings to prevent BD onset.

Purpose of the Study:

• To systematically review and identify instruments with predictive validity and utility for Bipolar Disorder (BD).
• To assess instruments for their effectiveness in early intervention (EI) for BD prevention.
• To evaluate instruments predicting BD onset in individuals without a prior diagnosis.

Main Methods:

• Systematic examination of studies predicting BD onset over at least 6 months.
• Inclusion of participants without diagnosed BD I or II at baseline.
• Rating instruments on validity and utility for BD prediction and EI, deriving Odds Ratios and AUC values where possible.

Main Results:

• Five instruments assessing sub-threshold symptoms, family history, temperament, and behavioral regulation were identified across six studies.
• No instruments were validated through high-quality replicated studies for BD prediction.
• The Child Behavioral Checklist - Pediatric BD phenotype (CBCL-PBD) and General Behavioral Inventory - Revised (GBI-R) demonstrated higher validity and utility.

Conclusions:

• Instruments targeting subthreshold symptoms, behavioral regulation, family history, and temperament show potential for predicting BD onset.
• Limitations include the exclusion of studies incidentally identifying BD on follow-up.
• Further high-quality research is needed to validate predictive instruments for early Bipolar Disorder intervention.