International Delphi consensus project

Towards a Consensus Definition of Treatment-Emergent Affective Switch (TEAS)

International Delphi Study in Mood Disorders

Treatment-emergent affective switch (TEAS) remains one of the most clinically relevant and inconsistently defined phenomena in mood disorders. This international Delphi study aims to develop a transparent, clinically useful consensus definition through structured expert consensus.

Protocol-led Study procedures are described in advance and will be linked through OSF.
Expert-based Participation is by invitation to international clinicians and researchers.
Transparent Results will be prepared for peer-reviewed publication.
About the study

Toward a shared operational definition of TEAS

Treatment-emergent affective switch remains one of the most clinically significant and inconsistently defined phenomena in mood disorders. Differences across definitions complicate clinical decision-making, the interpretation of research findings, and comparison across studies.

The aim of this project is to develop a consensus operational definition of TEAS through an international Delphi process involving invited experts in bipolar disorder, psychopharmacology, and mood disorders.

Study design

A structured international Delphi process

The study is designed to balance expert judgment, methodological transparency, and practical clinical relevance.

01

Expert invitation

Approximately 90 international experts are invited to participate in the panel.

02

Round 1

Participants rate and comment on proposed operational criteria and related clinical domains.

03

Round 2

Items are refined and re-rated based on aggregated expert feedback.

04

Optional round

An additional round may be conducted if consensus requires further clarification.

05

Consensus document

The final definition and rationale are prepared for dissemination and publication.

Transparency

Open science statement

The full protocol is available through OSF. The project will report its procedures, consensus thresholds, and final results in a transparent format suitable for peer review.

Ethics statement

The study is an expert consensus project and does not involve patient recruitment, patient data collection, or clinical intervention. The study protocol has been reviewed and approved by the Independent Ethics Committee of the V.M. Bekhterev National Medical Research Center.

Publication plan

The final consensus definition is intended to support clinical research, future guideline discussions, and harmonized reporting across studies of mood disorders.

Timeline
Protocol finalization Protocol preparation, expert list development, and survey setup.
Delphi rounds Two core survey rounds with an additional round if required.
Consensus manuscript Analysis, manuscript preparation, and dissemination of findings.
Study team

International scientific coordination

The project is coordinated by researchers with expertise in bipolar disorder, clinical psychopharmacology, psychiatric genomics, and consensus methodology.

Evgeny D. Kasyanov, MD, PhD

Principal Research Fellow. Head, Department of Genomics of Mental Disorders.

V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology.

Initiator and overall coordinator of the project.

Egor Shchepkin, MD

PhD student, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology

Technical implementation and primary statistical analysis.

Galina Mazo, MD, PhD

Associate Director for Innovative Scientific Development

Head of the Institute of Translational Psychiatry.

V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology.

Egor Chumakov, MD, PhD

Associate Professor, Department of Psychiatry and Addiction, Saint Petersburg State University

Scientific Advisor to the study. Responsible for international coordination and expert communication.

Martin Alda, MD, FRCPsych

Professor of Psychiatry, Dalhousie University, Canada

Internationally recognized expert in bipolar disorder and lithium treatment.

Scientific Advisor to the study.

For invited experts

What is expected from panel members?

Invited experts will complete short Delphi questionnaires and provide structured ratings and comments on proposed criteria.

Will responses be identifiable?

Individual responses will be treated confidentially and reported in aggregate form for consensus analysis.

How will contributors be acknowledged?

The final authorship and acknowledgement approach will be described in the study protocol and communicated transparently to participants.

Contact

Project coordination

For questions about the study protocol, expert participation, or project coordination, please contact the TEAS Consortium team.

Evgeny D. Kasyanov e.kasyanov.md@gmail.com Principal Research Fellow Head, Department of Genomics of Mental Disorders V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology ORCID: 0000-0002-4658-2195