Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review
Abstract Objectives The early pathogenesis and precursors of Bipolar Disorder (BD) are poorly understood. There is some cross-sectional and retrospective evidence of affective lability as a predictor of BD, but this is subject to recall biases. The present review synthesises the prospective evidence...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-11-01
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| Series: | International Journal of Bipolar Disorders |
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| Online Access: | https://doi.org/10.1186/s40345-021-00237-1 |
| _version_ | 1818823186870960128 |
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| author | Rosie H. Taylor Andrea Ulrichsen Allan H. Young Rebecca Strawbridge |
| author_facet | Rosie H. Taylor Andrea Ulrichsen Allan H. Young Rebecca Strawbridge |
| author_sort | Rosie H. Taylor |
| collection | DOAJ |
| description | Abstract Objectives The early pathogenesis and precursors of Bipolar Disorder (BD) are poorly understood. There is some cross-sectional and retrospective evidence of affective lability as a predictor of BD, but this is subject to recall biases. The present review synthesises the prospective evidence examining affective lability and the subsequent development of BD at follow-up. Methods The authors performed a systematic search of PubMed, PsycInfo and Embase (1960–June 2020) and conducted hand searches to identify studies assessing affective lability (according to a conceptually-inclusive definition) at baseline assessment in individuals without a BD diagnosis, and a longitudinal follow-up assessment of bipolar (spectrum) disorders. Results are reported according to the PRISMA guidelines, and the synthesis without meta-analysis (SWiM) reporting guidelines were used to strengthen the narrative synthesis. The Newcastle–Ottawa Scale was used to assess risk of bias (ROB). Results 11 articles describing 10 studies were included. Being identified as having affective lability at baseline was associated with an increased rate of bipolar diagnoses at follow-up; this association was statistically significant in six of eight studies assessing BD type I/II at follow-up and in all four studies assessing for bipolar spectrum disorder (BSD) criteria. Most studies received a ‘fair’ or ‘poor’ ROB grade. Conclusions Despite a paucity of studies, an overall association between prospectively-identified affective lability and a later diagnosis of BD or BSD is apparent with relative consistency between studies. This association and further longitudinal studies could inform future clinical screening of those who may be at risk of BD, with the potential to improve diagnostic accuracy and facilitate early intervention. |
| first_indexed | 2024-12-18T23:35:59Z |
| format | Article |
| id | doaj.art-af23b21484554302884c749f9230e65c |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-12-18T23:35:59Z |
| publishDate | 2021-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-af23b21484554302884c749f9230e65c2022-12-21T20:47:32ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112021-11-019111110.1186/s40345-021-00237-1Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic reviewRosie H. Taylor0Andrea Ulrichsen1Allan H. Young2Rebecca Strawbridge3Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonAbstract Objectives The early pathogenesis and precursors of Bipolar Disorder (BD) are poorly understood. There is some cross-sectional and retrospective evidence of affective lability as a predictor of BD, but this is subject to recall biases. The present review synthesises the prospective evidence examining affective lability and the subsequent development of BD at follow-up. Methods The authors performed a systematic search of PubMed, PsycInfo and Embase (1960–June 2020) and conducted hand searches to identify studies assessing affective lability (according to a conceptually-inclusive definition) at baseline assessment in individuals without a BD diagnosis, and a longitudinal follow-up assessment of bipolar (spectrum) disorders. Results are reported according to the PRISMA guidelines, and the synthesis without meta-analysis (SWiM) reporting guidelines were used to strengthen the narrative synthesis. The Newcastle–Ottawa Scale was used to assess risk of bias (ROB). Results 11 articles describing 10 studies were included. Being identified as having affective lability at baseline was associated with an increased rate of bipolar diagnoses at follow-up; this association was statistically significant in six of eight studies assessing BD type I/II at follow-up and in all four studies assessing for bipolar spectrum disorder (BSD) criteria. Most studies received a ‘fair’ or ‘poor’ ROB grade. Conclusions Despite a paucity of studies, an overall association between prospectively-identified affective lability and a later diagnosis of BD or BSD is apparent with relative consistency between studies. This association and further longitudinal studies could inform future clinical screening of those who may be at risk of BD, with the potential to improve diagnostic accuracy and facilitate early intervention.https://doi.org/10.1186/s40345-021-00237-1Bipolar disorderSystematic reviewAffective labilityMood instabilityProspectivePredictor |
| spellingShingle | Rosie H. Taylor Andrea Ulrichsen Allan H. Young Rebecca Strawbridge Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review International Journal of Bipolar Disorders Bipolar disorder Systematic review Affective lability Mood instability Prospective Predictor |
| title | Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review |
| title_full | Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review |
| title_fullStr | Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review |
| title_full_unstemmed | Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review |
| title_short | Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review |
| title_sort | affective lability as a prospective predictor of subsequent bipolar disorder diagnosis a systematic review |
| topic | Bipolar disorder Systematic review Affective lability Mood instability Prospective Predictor |
| url | https://doi.org/10.1186/s40345-021-00237-1 |
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