Impact of Duration of Untreated Bipolar Disorder on Clinical Outcomes: A Systematic Review

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2025-05-27 DOI:10.1111/eip.70059

Sara Ahmadieh Mena, Norma Verdolini, Salvador Miret, Nuria Laherrán, Samuel Pàmpols, Roberto Palacios-Garrán

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Abstract

Background

Bipolar disorder (BD) prognosis is influenced by multiple factors, including age, sex and comorbid conditions. This review focuses on the concept termed ‘duration of untreated bipolar disorder’ (DUB), defined as the interval between the onset of affective symptoms and the initiation of appropriate treatment. This variable may significantly influence the course and recovery of individuals with BD.

Objectives

The main objective is to determine whether an association exists between DUB and clinical outcomes in patients with BD, and to examine the potential implications of reducing DUB on the long-term prognosis of the disorder.

Methods

A systematic literature search was conducted using MeSH descriptors across the PubMed, Scopus, and Cochrane Library databases. A total of 1573 articles were initially identified. Following a rigorous screening and eligibility assessment process, a total of 15 articles met the inclusion criteria and were included in this review. The results obtained have been systematically analysed and synthesised for further evaluation.

Results

A prolonged DUB was associated with several clinical variables, including BD II, a longer duration of the illness, early age of onset, first episode of depressive polarity, higher number of depressive episodes and higher number of suicide attempts.

Limitations

There is currently no consensus on the definition or standardised measurement of DUB, which limits comparability across studies.

Conclusions

DUB appears to be a modifiable factor associated with poorer clinical outcomes in BD patients. Reducing DUB may improve long-term management of BD. Tailored early treatment strategies might be implemented to address this.

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未治疗双相情感障碍持续时间对临床结果的影响：一项系统综述

双相情感障碍（BD）的预后受多种因素的影响，包括年龄、性别和合并症。本综述的重点是“未治疗双相情感障碍持续时间”（DUB）的概念，定义为情感症状发作和开始适当治疗之间的时间间隔。该变量可能会显著影响双相障碍患者的病程和恢复。目的主要目的是确定双相障碍患者DUB与临床结果之间是否存在关联，并检查减少DUB对该疾病长期预后的潜在影响。方法利用MeSH描述符对PubMed、Scopus和Cochrane数据库进行系统文献检索。初步确定的物品总数为1573件。经过严格的筛选和资格评估过程，共有15篇文章符合纳入标准，被纳入本综述。所获得的结果已被系统地分析和综合，以供进一步评价。结果延长DUB与几个临床变量相关，包括BD II、病程较长、发病年龄较早、首次抑郁极性、抑郁发作次数较多和自杀企图次数较多。目前对DUB的定义或标准化测量尚无共识，这限制了研究之间的可比性。结论：DUB似乎是与BD患者临床预后较差相关的可改变因素。减少DUB可以改善BD的长期管理。量身定制的早期治疗策略可以解决这个问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.