Towards an Integrated Staging Model for Bipolar Disorders: An International Society for Bipolar Disorders ( ISBD ) Staging Task Force Consensus Report
Year: 2026
Type: article
Abstract: OBJECTIVES: Three clinical staging models for bipolar disorder (BD) have been published, each with a different but complementary approach and focus. The International Society for Bipolar Disorders Staging Task Force aimed to integrate these models into one comprehensive three-dimensional staging model, separately rating bipolar spectrum, nonmood psychopathology, and (inter-episodic) functional impairment. METHOD: Via a series of in-person and online meetings, Delphi-surveys, and email discussions, the task force members step-by-step reached consensus on the overall structure of the model and the definition of the various stages. RESULTS: The resulting BD staging model describes the progression of mood psychopathology, nonmood psychopathology, and functional impairment in three independently rated dimensions. The stages of the mood psychopathology are M0 (at risk for BD having a 1st or 2nd degree family member with BD); M1 (prodromal); M2 (first episode classifying for BD-I or BD-II); M3 (recurrent BD); and M4 (chronic unremitting BD), with various substages. Single or recurrent major depression in persons at familial risk for BD is positioned in stage M1. The stages for nonmood psychopathology are: N0 (no symptoms); N1 (subsyndromal symptoms); N2 (one nonmood disorder); N3 (two nonmood disorders); N4 (three or more nonmood disorders). The stages for functional impairment are: F0 (no); F1 (mild); F2 (moderate); F3 (marked); and F4 (severe impairment). Fictitious case vignettes are presented to demonstrate how to apply the model. Limitations of clinical staging are discussed. CONCLUSION: The proposed three-dimensional clinical staging model for illness progression comprehensively captures the complexity of illness presentation and heterogeneous illness progression in BD, including psychiatric comorbidities and degree of functional impairment. The model provides a framework that requires validation in research and clinical practice.
Source: Bipolar Disorders
DOI: 10.1111/bdi.70136
Authors: Ralph Kupka, Danella Hafeman, Madeleine McCallum, Afra van der Markt, Hailey Tremain, Martin Alda, Jorge Almeida, Taiane de Azevedo Cardoso, Vicent Balanzá‐Martínez, Boris Birmaher, David J. Bond, Elisa Brietzke, Ines Chendo, Iria Grande, Tomas Hajek, Manon Hillegers, Marcia Kauer‐Sant'Anna, Rodrigo Mansur, Ives Cavalcante Passos, Ana Gonzalez Pinto, Robert Post, Mauricio Tohen, Gustavo Vazquez, Eduard Vieta, Lakshmi N. Yatham, Flávio Kapczinski, Michael Berk, Anne Duffy
Institutions: Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam UMC Location Vrije Universiteit Amsterdam, University of Pittsburgh, Deakin University, Swinburne University of Technology, Dalhousie University, The University of Texas at Austin, Universitat de València, Centro de Investigación Biomédica en Red de Salud Mental, Hospital Clínico Universitario de Valencia, University of Pittsburgh Medical Center, Johns Hopkins University, Queen's University, University of Lisbon, Hospital de Santa Maria, Instituto de Salud Carlos III, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Erasmus MC, Erasmus MC - Sophia Children’s Hospital, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, University Health Network, University of Toronto, University of the Basque Country, George Washington University, University of New Mexico, University of New Mexico Health Sciences Center, University of British Columbia, St. Joseph’s Healthcare Hamilton, McMaster University, Barwon Health, The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Orygen, University of Oxford
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,730
Funders: Sanofi, Biogen, Patient-Centered Outcomes Research Institute, Teva Pharmaceutical Industries, University of Pennsylvania, Pennsylvania State University, Sunovion, Wellcome Trust, International Society for Bipolar Disorders, Ministerio de Ciencia, Innovación y Universidades, Centres de Recerca de Catalunya, Australian Government, Equity Trustees, University of Cambridge, University of Oxford, European Commission, Deakin University, ZonMw, Generalitat de Catalunya, Dainippon Sumitomo Pharma, Eusko Jaurlaritza, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Ministerio de Economía y Competitividad, Gedeon Richter, Generalitat Valenciana, Euskal Herriko Unibertsitatea, Lundbeckfonden, Ministerio de Ciencia e Innovación, Centro de Investigación Biomédica en Red de Salud Mental, Servier, Mitsubishi Tanabe Pharma Corporation, Casen Recordati, H. Lundbeck A/S, Idorsia Pharmaceuticals, Penn State College of Medicine, National Health and Medical Research Council, Instituto de Salud Carlos III, European Regional Development Fund, Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana, Daiichi Sankyo Europe, Congressionally Directed Medical Research Programs, Cilag
Awards: TRASTORNO BIPOLAR, ESTILO DE VIDA Y ESTRÉS OXIDATIVO, G1486922823, Development of a bench to bedside platform for novel therapy development for psychiatric disorders, G1934591525, G2416132163, G2739718152, G3589578312, G4644209160, G5327956434, ESTILO DE VIDA EN PRIMER EPISODIO MANIACO Y POTENCIACION FUNCIONAL, G5542049882, G6033524483, G6326635400, G636680540, G6844139850, SURVIVE 2: Un estudio de cohorte extendida para investigar la conducta suicida en España y la eficacia de estrategias de prevención secundaria: Eficacia funcional de iFD-Survive y correlatos biológicos, G713478339, Estilos de vida y aptitud física y sus correlatos biológicos como marcadores de síntomas de depresión y ansiedad en estudiantes universitarios: estudio de casos y controles anidado en la Cohorte UNILIFE-M
OpenAlex ID: W7165178775