van der Markt A, Klumpers UMH, Dols A, et al. - Clinical characteristics, such as familial loading, childhood abuse, age at onset, illness duration, comorbid psychiatric disorders, addiction, treatment resistance, and premorbid cognitive functioning, are assumed to determine the manifestation of bipolar disorder (BD). Researchers sought for a combination of clinical characteristics linked with progression to subsequent stages in two clinical staging models for BD.

• Researchers applied staging to determine the progression of bipolar-I-disorder (BD-I; N = 1396) using cross-sectional data from the Dutch Bipolar Cohort.

• Recurrence of mood episodes, ranging from prodromal to chronicity, primarily defined model A.

• Level of inter-episodic functioning, ranging from prodromal to inability to function autonomously, defined model B.

• For model A, the predictors for a higher stage were familial loading, childhood abuse, earlier onset, longer illness duration, psychiatric comorbidity, and treatment resistance in contrast to addiction and cognitive functioning.

• For model B, predictors for a more severe stage include childhood abuse, psychiatric comorbidity, cognitive functioning, and treatment resistance, whereas age at onset, illness duration, and addiction were not predictive.

• Based on findings, the construct validity of both staging models is supported.

• There appeared a large overlapping of characteristics linked with a higher stage across both models.