IMPROVING OUTCOMES OF BIPOLAR DISORDER: A MULTI-PRONGED STUDY

Guidelines provide treatment recommendations for the core group of bipolar disorder (BD) despite that 2/3 of patients feature more challenging presentation including poor functional outcomes, cognitive impairments, comorbid conditions, and lingering subsyndromal symptoms.

The ultimate goal of this project is to improve functional outcomes in BD by developing stratified clinical management methods based on cognitive test profiles, clinical presentation, and biomarkers that take the complex presentations of BD into account. To these ends, we utilize three conceptually complementary projects: The St.

Göran bipolar cohort, the Swedish bipolar collection, and the PREFECT-study.

Through follow-up and register linkage, we define empirically derived trajectory-based subtypes that distinguish patients with good prognosis from those with deleterious consequences of the disease; treatment responders from non-responders. We then elucidate driving biological and behavioral mechanisms.

We also aim to explore synaptic pathology in BD by analyzing synaptic markers in cerebrospinal fluid samples from BD cases and controls. Finally, we aim to develop a bed side test to monitor early signs of lithium induced nephropathy.

The scale of the studies, the breadth of collected data, the cross-disciplinary approach, and the longitudinal design allow us to study disease progression and determinants of long-term outcomes. The minimum of exclusion criteria in all studies makes results generalizable.