Bipolar disorder (BD) usually manifests in adolescence or early adulthood but is often diagnosed and treated only after a significant delay resulting in poor outcomes and high burden to the affected individuals, their families and the whole society. Efforts towards the detection and reliable assessment of at-risk states of BD and preventive measures have accelerated. Promising data on the prognostic validity of these at risk criteria are accumulating. Findings regarding potential prognostic biomarkers are emerging but are still sparse.
Detecting individuals at-risk of BD would eventually allow the prevention of this disorder, thus improving the lives of many young people. The essential translational steps to achieve such an ambitious goal are to (i) establish a harmonized clinical assessment package, including the evaluation of protective and resilience factors, (ii) defined a core biomarker assessment set that can be implemented into clinical routine, and (iii) deploy an integrated training material on the clinical and biomarker assessment to scale up the detection of emerging BD in real-world. To reach these objectives and increase scalable impact of preventive approaches for BD, we will harmonize two existing psychometric assessments for young people at risk of BD. Furthermore a core biomarker assessment set integrating neuro-biological, cognitive-emotional and social-behavioural pathomechanisms will be implemented. Training material will be deployed and disseminated. Researchers of three existing prospective cohorts of at-risk subjects of BD will then be trained to assess study participants with the harmonized clinical and biomarker package. The latter will include psychopathology, brain structure and function using MRI and EEG, cognition, genetics, body fluid analytes, natural speech/language, and passive/ecological momentary digital phenotyping. The exchange to King’s and TUD, respectively, will be integrated into the course of the different aspects of the project. This project will work with the world’s largest cohort of young people at clinical risk for BD ascertained with harmonized clinical and biomarker instruments.
- Pfennig A, Leopold K, Ritter P, Böhme A, Severus E, Bauer M. Longitudinal changes in the antecedent and early manifest course of bipolar disorder: A narrative review of prospective studies. Aust N Z J Psychiatry. 2017;51:509–23. doi:10.1177/0004867417700730.
- Faedda GL, Baldessarini RJ, Marangoni C, Bechdolf A, Berk M, Birmaher B, et al. An International Society of Bipolar Disorders task force report: Precursors and prodromes of bipolar disorder. Bipolar Disord. 2019;21:720–40. doi:10.1111/bdi.12831.
- Steardo L, Manchia M, Carpiniello B, Pisanu C, Squassina A. Clinical, genetic, and brain imaging predictors of risk for bipolar disorder in high-risk individuals. Expert Rev Mol Diagn. 2020;20:327–33. doi:10.1080/14737159.2020.1727743.
Skills/qualities required especially for this project:
- Interest in working with young people, psychopathology, neuroscience and precision medicine. Intellectual curiosity to acquire knowledge in multiple assessment techniques, artificial intelligence and work inter-disciplinary and translational