Psychiatry Investig.  2018 Aug;15(8):747-758. 10.30773/pi.2018.05.26.

The Staging of Major Mood Disorders: Clinical and Neurobiological Correlates

Affiliations
  • 1Islamic International Medical College, Riphah International University, Islamabad, Pakistan. muneerather2@gmail.com
  • 2Department of Psychiatry, Government Khawaja Safdar Medical College, Sialkot, Pakistan.

Abstract


OBJECTIVE
Staging of psychiatric disorders is gaining momentum and the purpose of this review is to examine whether major mood disorders can be defined according to stages.
METHODS
In April 2018 the PubMed electronic data base was scrutinized by a combination of various search terms like "major depressive disorder and staging,""bipolar disorder and neuroprogression," etc. To incorporate the latest findings the search was limited to the last 10 years. Both original and review articles were examined by reading the abstracts, and papers which were found to be particularly applicable were read in full and their reference lists were also consulted.
RESULTS
A significant increase occurred in the number of papers published on the topic of staging of mood disorders. Staging formats were found for both major mood disorders, with the caveat that many more articles were discovered for bipolar disorder. Current evidence points to allostatic load and neuroprogression as the basis for staging of mood disorders.
CONCLUSION
Principal affective illnesses may be characterized by distinct stages, for instance early, intermediate and late. These phases inform the management so that clinicians should incorporate the staging schema into everyday practice and implement treatment strategies according to the phase of the illness.

Keyword

Bipolar disorder; Major depressive disorder; Staging; Allostatic load; Neuroprogression

MeSH Terms

Allostasis
Bipolar Disorder
Depressive Disorder
Depressive Disorder, Major
Mood Disorders*
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