Editorial: Combining Genetic and Clinical Predictors of Bipolar Disorder: Towards Improving Diagnostic Precision in Youth.

Bipolar disorder (BD) is a complex, heterogeneous illness, with 60% to 85% of its variance attributed to genetic factors.1 Adolescence marks the first peak period of risk for the onset of BD, with the initial (hypo)manic episode often preceded by childhood psychopathology, including anxiety and sleep disorders, as well as internalizing symptoms.2 Given the non-specific nature of childhood antecedents, combined with the prominence of depressive episodes in the early illness course, accurate diagnosis is often delayed by 8 to 10 years from onset.3 Yet, the early course of BD in youth is already associated with significant morbidity and mortality. Therefore, more accurate and timely diagnosis is a priority. One way forward could be to combine biomarkers with clinical variables to help validate diagnoses, improve individual risk prediction and treatment, and advance discovery research into pathogenesis.