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Abstract Body

Although BD is a heterogeneous disorder, the diagnosis of the core syndrome, bipolar I disorder (BDI), is one of the three most reliable diagnoses in psychiatry and has good predictive validity for future disease course and outcome. Mood stabilizers are the mainstay of treatment of BDI, and Lithium is the most consistently recommended first-line treatment in clinical practice guidelines. However, the criteria for prescribing Lithium are primarily dictated by a clinical response phenotype and a trial of medication to determine any benefits. Such trials usually last about two years to allow full assessment of the impact of Lithium on the number, frequency and severity of manic and depressive episodes. At present, around 30-55% of individuals selected for treatment with Lithium will not have the good outcome predicted – that is, even though the clinical response phenotype can be reliably described it has insufficient predictive validity on its own. Important research efforts are being dedicated to the development and the validation of predictive biomarkers to guide clinicians in the management of bipolar disorders, in particular with respect to lithium prescription.