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.