To effectively treat mental disorders, it is crucial to identify and utilize a specific target or "mechanism of action." In regards to bipolar disorder, research has shown promising results in focusing on abnormalities within the sleep and circadian systems.

University of Pittsburgh

Having a positive family history of bipolar disorder (BP) is a strong risk factor for developing the condition, especially among first-degree relatives. It can lead to earlier onset and more severe illness. Studies show that 5-19% of offspring of parents with BP develop BP themselves by young adulthood. These offspring also face a higher risk of other psychiatric conditions like depression and anxiety, making them an easily identifiable population at ultra-high risk for early-onset psychiatric disorders, particularly BP.

Youth At-Risk for Bipolar Disorder

Goldstein TR, Fersch-Podrat RK, Axelson DA, Gilbert A, Hlastala S, Birmaher B, Frank E. Early Intervention for adolescents at high risk for the development of bipolar disorder: Pilot study of Interpersonal and Social Rhythm Therapy (IPSRT). Psychotherapy. 2014 Mar;51(1):180-189.

Early Intervention for adolescents at high risk for the development of bipolar disorder: Pilot study of Interpersonal and Social Rhythm Therapy (IPSRT).

Rate scale:
1. High-risk, asymptomatic=0
2. Family history and non-specific symptoms/subthreshold manic symptoms=1; 
3. Full hypo/manic episode=2; 
4. Recurrent/chronic illness with functional impairment=3-4

Youth in stages 0-1 do not already meet the criteria for a BP spectrum or mood disorder, which means current treatment for BP may not work well on them.

Use Clinical Staging Model to Classifying and Treating Youth of High Risk of BP

1. Family Focused Therapy for High-Risk Children (FFT-HR)
2. Interpersonal and Social Rhythm Therapy (IPSRT)
3. Dialectical Behavior Therapy (DBT)

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