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August 2016
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Neuroprogression and Staging in Bipolar Disorder

By Flavio Kapczinski, Eduard Vieta, Pedro Magalhaes & Michael Berk

A staging system is a heuristic tool intended to add prognostic significance to clinical diagnoses.  If able to use valid staging models, the clinician is armed with information capable of aiding in selection of specific strategies for treatment.  An already firmly established strategy in clinical medicine, from fields as disparate as oncology and rheumatology, neurology and nephrology, prognostic staging has been gaining traction in psychiatry in the past 10 years. 

There is now consistent evidence that, at least for a significant portion of people with bipolar disorder, clinical course and outcome are not as benign as initially described.  The evidence thus far points to relevant differences between early and late stages of bipolar disorders in clinical course of illness, neurobiology and systemic pathology.  These all suggest staging is a viable addition to clinical care in bipolar disorder. 

This book provides a comprehensive and scholarly discussion on the current state of the evidence regarding staging systems in bipolar disorder.  Edited by the leading researchers in the field, the book counts on the expertise of prominent authors to cover a breadth of topics of interest for clinicians and researchers alike. 

Among the topics systematically covered are (1) the history and theoretical basis for staging, (2) comparisons between different proposals, (3) neurobiological underpinnings, including neuroimaging, biological markers, (4) the current evidence-base, (5) limitations and future directions and (6) clinical implications and recommendations for practice. 

As a first attempt to discuss comprehensively staging and neuroprogression, we see this volume as novel work by expert clinician researchers for those treating people with bipolar disorder and working with clinical and basic investigation in the field.  The book is intended to provide a solid, in depth outline of the basis and utility of staging models and thus influence research and practice in the field of bipolar disorder. 

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