Impact of Duration Untreated Bipolar Disorder on Clinical Outcomes: A
Systematic Review
Abstract
Background. Bipolar disorder (BD) is a chronic affective mental
disorder characterized by cycling affective episodes. Its prognosis
depends on several factors such as age, sex or comorbidities. In this
review, we will focus on the so-called ”duration of untreated bipolar
disorder” (DUB), defined as the period between the onset of the
patient’s symptoms and the start of an appropriate treatment, since it
may have an influence on the recovery of BD patients.
Objectives. The main objective is to assess the association
between the DUB and the clinical outcomes of patients with BD and to
highlight the importance of reducing the DUB to improve the prognosis of
this disease. Methods. The search strategy is based on using
Mesh descriptors in different databases: PubMed, Scopus, and Cochrane
Library. Then, 15 articles were finally selected. The results obtained
have been reflected for subsequent systematic evaluation.
Results. A prolonged DUB is associated with the presence of BD
subtype II, a longer duration of the illness, an early age of onset, a
first episode of depressive polarity, a higher number of affective
episodes of depressive type, and a higher number of suicide attempts.
Limitations: The concept of DUB lacks consensus leading to
varied terminology and limited research. Unlike psychotic disorders,
there’s no standardized tool to measure DUB. Conclusions. DUB
appears to be a modifiable factor linked to poorer outcomes in BD
patients. Minimizing DUB is crucial for enhancing the long-term
management of BD. Tailored early treatment strategies might be
implemented to address this.