Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment

BACKGROUND: Little is known about predictors of recovery from bipolar depression. AIMS: We investigated affective instability (a pattern of frequent and large mood shifts over time) as a predictor of recovery from episodes of bipolar depression and as a moderator of response to psychosocial treatment for acute depression. METHOD: A total of 252 out-patients with DSM-IV bipolar I or II disorder and who were depressed enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and were randomised to one of three types of intensive psychotherapy for depression (n = 141) or a brief psychoeducational intervention (n = 111). All analyses were by intention-to-treat. RESULTS: Degree of instability of symptoms of depression and mania predicted a lower likelihood of recovery and longer time until recovery, independent of the concurrent effects of symptom severity. Affective instability did not moderate the effects of psychosocial treatment on recovery from depression. CONCLUSIONS: Affective instability may be a clinically relevant characteristic that influences the course of bipolar depression.

Lab-on-a-chip or chip-in-a-lab: challenges of commercialization lost in translation

Lab-on-a-chip technology has been long envisaged to have tremendous commercial potential, owing to the ability of such devices to encapsulate a full range of laboratory processes in a single instrument and operate in a portable manner, rapidly and at low cost. Devices are believed to have potential in fields ranging across medical diagnostics, environmental sampling and a range of consumer products, however, to date very few devices have attained commercial success. This review examines the challenges relating to the commercialization of lab-on-a-chip technology from fundamental research to mass manufacturing and aims to provide insight to both academics and product development specialists the perceived hindrances to commercialization and a strategy by which future work could be translated into commercial success.