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Bipolar disorder is a complex disease and requires specialized care for its assessment and effective treatment. It has a worldwide prevalence of about 2% and is among the top 10 leading causes of disability adjusted life years in young adults. Additionally, people with bipolar disorder die around 10 years earlier, and the lifetime risk of suicide is estimated to be at least 20 times that of the general population. Although these findings illustrate the severity and complexity of this illness, we are living exciting times in the field of bipolar disorder for several reasons. Over the last 20...

After the original proposals of staging for psychotic disorders developed by McGorry and colleagues, a few systems have been put forward specifically for people with bipolar disorder. There is now consistent evidence that, at least for a significant portion of people with this disease, clinical course and outcome are not as benign as initially described. The evidence thus far points to relevant differences between early and late stages of bipolar disorders in the clinical course of illness, neurobiology and systemic pathology. These differences all suggest that staging is a viable addition to...