Diagnosis and treatment in the early illness phase of bipolar disorders.

The combination of a long undetected illness and significant psychosocial impairment renders early identification and intervention a vital role in bipolar disorders. Early detection forms the basis for adequate education and for treatment from the beginning. Several lines of evidence indicate that the characterization of early phases in the development of bipolar disorders is feasible. Risk factors for the development of bipolar disorders have been established and a manic prodrome has been characterized that is sufficiently long to allow recognition and, potentially, intervention. Centers specifically focussing on early detection and prevention of bipolar disorders need to be established. More research in this field is warranted including both groups of symptomatic subjects and symptom-free persons, with and without a positive family history.