ABSTRACT
Subsyndromal bipolar symptoms are common during maintenance treatment and appear to be associated with relapse into an episode of the same polarity. This implies subsyndromal symptoms are an important problem in recurrent bipolar disorder and require more additive and infallible therapeutic intervention. Undetected, untreated subsyndromal states lead patients to have poor prognosis and quality of life. The combination of a long undetected illness and significant psychosocial impairment renders early identification and intervention vital for the treatment of bipolar disorders. Methods for early identification includes finding prodromes, using screening tools such as the HCL-32 (Hypomania Checklist-32) and the BSDS (bipolar spectrum diagnostic scale). Various augmentation treatment methods would be needed to reduce subsyndromal symptoms, especially, psychosocial treatment has the potential to help patients address the multiple psychosocial problems associated with this chronic illness. To overcome difficulties of diagnosing subsyndromal disorder and to treat it appropriately, a staging system was suggested by some researchers. It assumes that earlier stages have better prognosis and require simpler therapeutic regimens. Staging may assist in treatment planning and prognosis of bipolar disorder, and emphasize the importance of early intervention. Further research is required in this exciting and novel area.