Mood instability as prodrome of bipolar disorder

Bipolar disorder and affective disorders exhibit progressive trajectories, involving central and peripheral biological changes and diverse clinical courses. This review explores the development of clinical staging models for bipolar disorder, aiming to identify critical points in the disorder's progression. Staging models, whether disorder-specific or transdiagnostic, offer a promising avenue for tailoring treatments based on social factors and patient resilience. A key aspect in the field of affective disorders is the study of prodromal symptoms. Recognizing prodromal symptoms, particularly mood instability, provides an important opportunity for timely intervention. Prospective studies utilizing neuroimaging and genetic tools in at-risk youth show promise in predicting future affective lability and potential full expression of the disorder. Challenges persist in the research concerning affective disorders, including the lack of clear definitions for stages and specific personality traits predicting mood disorders. Endophenotypes and biomarkers present potential tools to reduce heterogeneity, offering more precise diagnoses and tailored treatments. Early white matter abnormalities may serve as markers of bipolar disorder pathophysiology, suggesting the potential for early interventions. In conclusion, recognizing prodromal symptoms is crucial for early interventions in affective disorders. Psychoeducation enhances patient compliance and outcomes, emphasizing ongoing awareness of prodromal symptoms during remission. Continued treatment in the residual phase aligns with a staging method for long-term prevention. The evolving landscape of affective disorders research calls for a nuanced understanding to advance comprehension and treatment.