Early diagnosis of bipolar disorder

Bipolar disorder (BD) is a severe mood disorder characterized by recurrent episodes of mania and depression, and it is prone to delayed diagnosis, which can lead to worsened outcomes, including more frequent mood episodes, greater functional impairment, and comorbidities. Early diagnosis of BD remains a significant challenge, although recent advances offer promising insights, such as research in molecular biomarkers, neuroimaging, exosomes, genetics, and epigenetics. This mini-review highlights their potential for providing earlier, more accurate identification of BD and discusses the underlying reasons why current research has not yet succeeded. For instance, the high heterogeneity of symptomatic presentations leads to low consistency in study participants; delayed BD diagnosis results in the inclusion of potential BD patients in the depression group; low specificity of biomarkers stems from limited understanding of BD pathophysiology; and there is a possibility that BD is not innate but develops over the course of the disease. Deepening our understanding of BD pathology, identifying more specific biomarkers, and integrating multiomics approaches for validation studies in well-defined homogeneous cohorts hold promise for significant breakthroughs.