目的:临床分期在医学中广泛用于绘制疾病进展图,告知预后,并指导治疗决策;在精神病学中,然而,分期仍然是一个假设的结构。为了促进双相情感障碍(BD)的未来研究,需要一个明确定义的术语,特别是由于诊断通常不精确,边界模糊,缺乏对病理生理学的全面了解。
方法:在国际双相情感障碍学会的主持下,召集了国际专家工作队进行审查,讨论,并整合与共识分期模型开发相关的科学文献中的发现,并标准化可用于推进未来研究的术语,包括BD和相关疾病的分期。
结果:关于可能适用于BD的分期术语,确定了共识意见和不确定性或差异领域。处于风险状态和亚阈值阶段,以及目前诊断的BD的各个临床阶段。
结论:关于BD临床分期的标准化命名法的使用将促进关于该异质性疾病组的临床和病理成分研究的交流。提出的概念是基于当前的证据,但是随着病因学进展的出现,提供的模板允许进一步完善。
OBJECTIVE: Clinical staging is widely used in medicine to map disease progression, inform prognosis, and guide treatment decisions; in psychiatry, however, staging remains a hypothetical construct. To facilitate future research in bipolar disorders (BD), a well-defined nomenclature is needed, especially since diagnosis is often imprecise with blurred boundaries, and a full understanding of pathophysiology is lacking.
METHODS: Under the auspices of the International Society of Bipolar Disorders, a Task Force of international experts was convened to review, discuss, and integrate findings from the scientific literature relevant to the development of a
consensus staging model and standardize a terminology that could be used to advance future research including staging of BD and related disorders.
RESULTS: Consensus opinion and areas of uncertainty or difference were identified in regard to terms referring to staging as it may apply to BD, to at-risk status and subthreshold stages, and to various clinical stages of BD as it is currently diagnosed.
CONCLUSIONS: The use of a standardized nomenclature about the clinical stages of BD will facilitate communication about research on clinical and pathological components of this heterogeneous group of disorders. The concepts presented are based on current evidence, but the template provided allows for further refinements as etiological advances come to light.