Semistructured Interview for Bipolar At Risk States (SIBARS).

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• The external prognostic accuracy of Bipolar At Risk (BAR) criteria for predicting bipolar disorders is unclear.
• No validated psychometric tools exist for assessing these risk criteria.

Purpose of the Study:

• To evaluate the prognostic accuracy of original BAR criteria, revised Bipolar At Risk States (BARS) criteria, and a newly developed Semistructured Interview of At Risk Bipolar States (SIBARS).
• To assess the utility of SIBARS in identifying individuals at risk for bipolar disorders within Clinical High Risk for Psychosis (CHR-P) services.

Main Methods:

• Retrospective cohort study (n=205) evaluating BAR and BARS criteria prognostic accuracy (Harrell's C) for bipolar disorder development in CHR-P individuals.
• Prospective cohort study (n=71) externally validating the prognostic accuracy and clinical utility of the SIBARS in an independent CHR-P cohort.

Main Results:

• Original BAR criteria showed poor prognostic accuracy (Harrell's C=0.659) despite increased bipolar disorder risk (HR=5.30).
• Revised BARS criteria demonstrated adequate prognostic accuracy (Harrell's C=0.777) with a significantly higher risk (HR=12.364).
• SIBARS criteria achieved adequate prognostic accuracy (Harrell's C=0.742) and clinical utility in the prospective validation.

Conclusions:

• The revised BARS criteria offer improved prognostic accuracy over original BAR criteria for bipolar disorder prediction in CHR-P individuals.
• The SIBARS is a promising tool for detecting individuals at risk of developing bipolar disorders within CHR-P services, demonstrating adequate prognostic accuracy and clinical utility.