Toward stratified treatments for bipolar disorders

Hasler, Gregor; Wolf, Andreas (2015). Toward stratified treatments for bipolar disorders. European neuropsychopharmacology, 25(3), pp. 283-294. Elsevier 10.1016/j.euroneuro.2014.12.006

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In bipolar disorders, there are unclear diagnostic boundaries with unipolar depression and schizophrenia, inconsistency of treatment guidelines, relatively long trial-and-error phases of treatment optimization, and increasing use of complex combination therapies lacking empirical evidence. These suggest that the current definition of bipolar disorders based on clinical symptoms reflects a clinically and etiologically heterogeneous entity. Stratification of treatments for bipolar disorders based on biomarkers and improved clinical markers are greatly needed to increase the efficacy of currently available treatments and improve the chances of developing novel therapeutic approaches. This review provides a theoretical framework to identify biomarkers and summarizes the most promising markers for stratification regarding beneficial and adverse treatment effects. State and stage specifiers, neuropsychological tests, neuroimaging, and genetic and epigenetic biomarkers will be discussed with respect to their ability to predict the response to specific pharmacological and psychosocial psychotherapies for bipolar disorders. To date, the most reliable markers are derived from psychopathology and history-taking, while no biomarker has been found that reliably predicts individual treatment responses. This review underlines both the importance of clinical diagnostic skills and the need for biological research to identify markers that will allow the targeting of treatment specifically to sub-populations of bipolar patients who are more likely to benefit from a specific treatment and less likely to develop adverse reactions.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Healthcare Research

UniBE Contributor:

Hasler, Gregor and Wolf, Andreas

Subjects:

600 Technology
600 Technology > 610 Medicine & health

ISSN:

0924-977X

Publisher:

Elsevier

Language:

English

Submitter:

Gregor Hasler

Date Deposited:

18 Jan 2016 12:14

Last Modified:

30 Dec 2016 11:29

Publisher DOI:

10.1016/j.euroneuro.2014.12.006

PubMed ID:

25595029

Uncontrolled Keywords:

Bipolar disorder; Stratified medicine; Personalized medicine; Precision medicine; Treatment optimization

BORIS DOI:

10.7892/boris.74438

URI:

https://boris.unibe.ch/id/eprint/74438

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