Effectiveness of treatment earlier vs later in illness course in people with bipolar disorder: A literature review

Katie Joyce1, Andrew Thompson, Steven Marwaha; 1University of Warwick

Background: Bipolar disorder affects 2% of the UK population and is within the top 4 main causes of disability adjusted life years (DALYS) for 10-24 year olds world-wide. On average, it costs the UK £2 billion annually. Current literature on early intervention in bipolar disorder is limited and there is a lack of research on the effect of earlier treatment onset on outcome in bipolar disorder. Aim: To investigate whether initiation of treatment in an earlier stage of bipolar disorder results in improved outcomes. Method: Literature search of Medline, Embase, Psychinfo, PsycArticle and Web of Science, with a subsequent narrative review of relevant papers. Results: Our search strategy yielded eight papers. There was a consistent finding amongst literature that earlier treatment initiation resulted in better outcomes. Further to this, earlier treatment of bipolar patients affected several domains including psychosocial functioning, symptomatic recovery, increased employment, reduced brain loss and reduced cognitive damage. The literature varied on when early intervention must occur by in order to improve outcomes. Conclusion: This review would suggest that, despite the limited despite limited current research studies,, earlier treatment resulting in better outcome is a common finding. To identify the pivotal point at which early intervention must occur requires more research. However, the results generally support the use of an early intervention service in bipolar disorder to improve patient outcomes.

Topic Area: Mood Disorders

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