Pródromos e estados de risco para transtorno bipolar: oportunidades para prevenção

Autores

  • Mariane Nunes Noto Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP.
  • Adiel Rios Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP.
  • Mariana Pedrini Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP.
  • Elisa Brietzke Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP.

DOI:

https://doi.org/10.25118/2763-9037.2016.v6.119

Palavras-chave:

Bipolar, mania, pródromos, fases iniciais

Resumo

O transtorno bipolar (TB) é uma doença psiquiátrica crônica e potencialmente grave. Nos últimos anos, pesquisas que focaram nas fases prodrômicas e iniciais do TB demonstraram que estratégias de detecção e intervenção precoces têm o potencial de atrasar, diminuir a severidade ou prevenir episódios completos do TB. Dessa forma, um novo caminho se apresenta para a clínica dos transtornos do humor, que passa não só a preocupar-se com o tratamento dos episódios de mania e depressão, como a buscar a detecção e o diagnóstico precoce e, fundamentalmente, a prevenção. O objetivo deste artigo é discutir dados da literatura sobre as fases iniciais do TB, os desafios da detecção precoce e as implicações desse enfoque para intervenções e manejo clínico antes ou logo após o desenvolvimento do primeiro episódio de mania, que marca, oficialmente, o início da doença.

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...

Referências

Post RM, Denicoff KD, Leverich GS, Altshuler LL, Frye MA, Suppes TM, et al. Morbidity in 258 bipolar outpatients followed for 1 year with daily prospective ratings on the NIMH life chart method. J Clin Psychiatry. 2003;64:680-90; quiz 738-9.

Murray CJ, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge: Harvard University; 1996.

Kapczinski F, Vieta E, Andreazza AC, Frey BN, Gomes FA, Tramontina J, et al. Allostatic load in bipolar disorder: implications for pathophysiology and treatment. Neurosci Biobehav Rev. 2008;32:675-92.

Berk M, Conus P, Lucas N, Hallam K, Malhi GS, Dodd S, et al. Setting the stage: from prodrome to treatment resistance in bipolar disorder. Bipolar Disord. 2007;9:671-8.

Kapczinski F, Dias VV, Kauer-Sant’Anna M, Frey BN, Grassi-Oliveira R, Colom F, et al. Clinical implications of a staging model for bipolar disorders. Expert Rev Neurother. 2009;9:957-66.

Berk M, Hallam KT, McGorry PD. The potential utility of a staging model as a course specifier: a bipolar disorder perspective. J Affect Disord. 2007;100:279-81.

Berk M, Kapczinski F, Andreazza AC, Dean OM, Giorlando F, Maes M, et al. Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev. 2011;35:804-17.

Brietzke E, Mansur RB, Soczynska JK, Kapczinski F, Bressan RA, McIntyre RS. Towards a multifactorial approach for prediction of bipolar disorder in at risk populations. J Affect Disord. 2012;140:82-91.

McGorry PD, Yung AR. Early intervention in psychosis: an overdue reform. Aust N Z J Psychiatry. 2003;37:393-8.

McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ. Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry. 2006;40:616-22.

Taylor M, Bressan RA, Pan Neto P, Brietzke E. Early intervention for bipolar disorder: current imperatives, future directions. Rev Bras Psiquiatr. 2011;33:s197-212.

Bechdolf A, Ratheesh A, Wood SJ, Tecic T, Conus P, Nelson B, et al. Rationale and first results of developing at-risk (prodromal) criteria for bipolar disorder. Curr Pharm Des. 2012;18:358-75.

Singh MK. Is there validity to the bipolar prodrome? J Clin Psychiatry. 2015;76:e655-6.

Rios AC, Noto MN, Rizzo LB, Mansur R, Martins FE Jr, Grassi-Oliveira R, et al. Early stages of bipolar disorder: characterization and strategies for early intervention. Rev Bras Psiquiatr. 2015;37:343-9.

Passos IC, Jansen K, Kapczinski F. Developmental staging models in bipolar disorder. Int J Bipolar Disord. 2015;3:33.

Scott J. Bipolar disorder: from early identification to personalized treatment. Early Interv Psychiatry. 2011;5:89-90.

Correll CU, Hauser M, Penzner JB, Auther AM, Kafantaris V, Saito E, et al. Type and duration of subsyndromal symptoms

in youth with bipolar I disorder prior to their first manic episode. Bipolar Disord. 2014;16:478-92.

Goetz M, Novak T, Vesela M, Hlavka Z, Brunovsky M, Povazan M, et al. Early stages of pediatricbipolar disorder: retrospecti ve analysis of a Czech inpati ent sample. Neuropsychiatr Dis Treat. 2015;11:2855-64.

Noto MN, Noto C, Caribe AC, Miranda-Scippa Â, Nunes SO, Chaves AC, et al. Clinical characteristi cs and infl uence of childhood trauma on the prodrome of bipolar disorder. Rev Bras Psiquiatr. 2015;37:280-8.

Bellivier F, Golmard JL, Rietschel M, Schulze TG, Malafosse A, Preisig M, et al. Age at onset in bipolar I aff ecti ve disorder: further evidence for three subgroups. Am J Psychiatry. 2003;160:999-1001.

Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the Nati onal Comorbidity Survey Replicati on (NCS-R). JAMA. 2003;289:3095-105.

Egeland JA, Hostett er AM, Pauls DL, Sussex JN. Prodromal symptoms before onset of manicdepressive disorder suggested by fi rst hospital admission histories. J Am Acad Child Adolesc Psychiatry. 2000;39:1245-52.

Fergus EL, Miller RB, Luckenbaugh DA, Leverich GS, Findling RL, Speer AM, et al. Is there progression from irritability/dyscontrol to major depressive and manic symptoms? A retrospecti ve community survey of parents of bipolar children. J Aff ect Disord. 2003;77:71-8.

Rucklidge JJ. Retrospecti ve parent report of psychiatric histories: do checklists reveal specifi c prodromal indicators for postpubertalonset pediatric bipolar disorder? Bipolar Disord. 2008;10:56-66.

Skjelstad DV, Malt UF, Holte A. Symptoms and signs of the initi al prodrome of bipolar disorder: a systemati c review. J Aff ect Disord. 2010;126:1-13.

Birmaher B, Axelson D, Goldstein B, Strober M, Gill MK, Hunt J, et al. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the Course and Outcome of Bipolar Youth (COBY) study. Am J Psychiatry. 2009;166:795-804.

Bechdolf A, Nelson B, Cott on SM, Chanen A, Thompson A, Kett le J, et al. A preliminary evaluati on of the validity of at-risk criteria for bipolar disorders in help-seeking adolescents and young adults. J Aff ect Disord. 2010;127:316-20.

Bechdolf A, Ratheesh A, Cott on SM, Nelson B, Chanen AM, Bett s J, et al. The predicti ve validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospecti ve study. Bipolar Disord. 2014;16:493-504.

McNamara RK, Strawn JR, Chang KD, DelBello MP. Interventi ons for youth at high risk for bipolar disorder and schizophrenia. Child Adolesc Psychiatr Clin N Am. 2012;21:739-51.

Bauer M, Juckel G, Correll CU, Leopold K, Pfennig A. Diagnosis and treatment in the early illness phase of bipolar disorders. Eur Arch Psychiatry Clin Neurosci. 2008;258:50-4.

Downloads

Publicado

2016-10-31

Como Citar

1.
Noto MN, Rios A, Pedrini M, Brietzke E. Pródromos e estados de risco para transtorno bipolar: oportunidades para prevenção. Debates em Psiquiatria [Internet]. 31º de outubro de 2016 [citado 1º de fevereiro de 2023];6(5):32-7. Disponível em: https://revistardp.org.br/revista/article/view/119

Edição

Seção

Artigos de Atualização

Plaudit

Métricas