Introduction: Early detection and intervention in bipolar disorder (BD) might reduce illness severity, slow its progression, and, in specific cases, even ward off the full-blown disorder. Therefore, identifying at-risk individuals and targeting them promptly before the illness onset is of the utmost importance. In the last decades, there has been a significant effort aimed at identifying genetic and molecular factors able to modulate risk and pharmacological outcomes.Areas covered: We performed a narrative review of articles aimed at identifying clinical, genetics, molecular, and brain imaging markers of BD specifically focusing on samples of individuals at high-risk for BD. Special emphasis was put on studies applying an integrative design, e.g. studies combining different markers such as genetic and brain imaging.Expert opinion: Findings from studies in risk individuals are still too sparse to allow drawing definite conclusions. However, the high potentiality of longitudinal studies in individuals considered at risk to develop BD supports the need for more efforts. Future investigations should focus on more homogeneous subpopulations and evaluate the cross-linking between clinical, genetic, and brain morphostructural/functional neuroimaging characteristics as predictors of risk for BD.

中文翻译：

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临床，遗传和大脑影像学预测因素可预测高危个体双相情感障碍的风险。

简介：对双相情感障碍（BD）的早期发现和干预可能会降低疾病的严重程度，减缓其进展，甚至在某些情况下甚至可以避免这种疾病。因此，最重要的是识别出高危人群并在疾病发作之前迅速将其作为目标。在过去的几十年中，人们做出了巨大的努力，旨在鉴定能够调节风险和药理结果的遗传和分子因素。涵盖领域：我们对文章进行了叙述性综述，旨在鉴定临床，遗传学，分子和脑影像学标志物BD专门针对BD高危人群的样本。特别强调采用综合设计的研究，例如结合遗传和脑成像等不同标记的研究。专家意见：风险人群研究的结果仍然很少，无法得出明确的结论。但是，在被认为有患BD危险的个体中进行纵向研究的潜力很高，这表明需要进行更多的努力。未来的研究应集中在更均质的亚群上，并评估临床，遗传和脑形态结构/功能性神经影像学特征之间的交叉联系，作为预测BD风险的指标。