Early symptoms of bioplar affective psychosis: research and clinical implications

Review of the available literature shows that BP psychosis rarely reveals itself earlier in life, either by alternate psychiatric illness or by impairment in educational or occupational achievement. There is some evidence from early onset cases that the illness can evolve slowly but systematic studies are lacking. The possibility is raised that what was previously regarded as a premorbid "affective" (cyclothymic or hypomanic) personality may represent the early stages of the illness itself. This view requires prospective validation. Some research implications are discussed.