Biomarkers in bipolar disorder: A positional paper from the International Society for Bipolar Disorders Biomarkers Task Force

Benicio N. Frey, Ana C. Andreazza, Josselin Houenou, Stéphane Jamain, Benjamin I. Goldstein, Mark A. Frye, Marion Leboyer, Michael Berk, Gin S. Malhi, Carlos Lopez-Jaramillo, Valerie H. Taylor, Seetal Dodd, Sophia Frangou, Geoffrey B. Hall, Brisa S. Fernandes, Marcia Kauer-Sant'Anna, Lakshmi N. Yatham, Flavio Kapczinski, L. Trevor Young

Research output: Contribution to journalReview articlepeer-review

192 Scopus citations


Although the etiology of bipolar disorder remains uncertain, multiple studies examining neuroimaging, peripheral markers and genetics have provided important insights into the pathophysiologic processes underlying bipolar disorder. Neuroimaging studies have consistently demonstrated loss of gray matter, as well as altered activation of subcortical, anterior temporal and ventral prefrontal regions in response to emotional stimuli in bipolar disorder. Genetics studies have identified several potential candidate genes associated with increased risk for developing bipolar disorder that involve circadian rhythm, neuronal development and calcium metabolism. Notably, several groups have found decreased levels of neurotrophic factors and increased pro-inflammatory cytokines and oxidative stress markers. Together these findings provide the background for the identification of potential biomarkers for vulnerability, disease expression and to help understand the course of illness and treatment response. In other areas of medicine, validated biomarkers now inform clinical decision-making. Although the findings reviewed herein hold promise, further research involving large collaborative studies is needed to validate these potential biomarkers prior to employing them for clinical purposes. Therefore, in this positional paper from the ISBD-BIONET (biomarkers network from the International Society for Bipolar Disorders), we will discuss our view of biomarkers for these three areas: neuroimaging, peripheral measurements and genetics; and conclude the paper with our position for the next steps in the search for biomarkers for bipolar disorder.

Original languageEnglish
Pages (from-to)321-332
Number of pages12
JournalAustralian and New Zealand Journal of Psychiatry
Issue number4
StatePublished - Apr 2013
Externally publishedYes


  • Biomarkers
  • Bipolar disorder
  • Inflammation
  • Neutrophins
  • Oxidative stress


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