BACKGROUND: In contrast to differential diagnosis (ddx) of older adolescent and adult bipolarity (BP), which includes schizophrenia and substance use disorders, the main ddx of prepubertal and early adolescent BP is attention-deficit disorder with hyperactivity (ADHD). To address this ddx issue, and to provide prepubertal mania manifestations, interim baseline data are presented from the National Institute of Mental Health (NIMH)-funded study 'Phenomenology and Course of Pediatric Bipolarity'. METHODS: Data are from the first 60 BP and the first 60 ADHD cases from 270 consecutively ascertained subjects (90 BP, 90 ADHD and 90 community controls). Comprehensive assessments included the Washington University at St. Louis Kiddie and Young Adult-Schedule for Affective Disorders and Schizophrenia--Lifetime and Present Episode Version-DSM-IV (WASH-U-KSADS) blindly administered by nurses to mothers about their offspring and to children/adolescents about themselves. Caseness was established by consensus conferences that included diagnostic and impairment data, teacher and school reports, agency records, videotapes and medical charts. RESULTS: Mean baseline age of BP cases was 11.0+/-2.7 years and the mean age at onset of BP was 8.1+/-3.5 years. Elated mood, grandiosity, hypersexuality, decreased need for sleep, racing thoughts and all other mania items except hyperenergetic and distractibility were significantly and substantially more frequent among BP than ADHD cases (e.g., elation: 86.7% BP vs. 5.0% ADHD; grandiosity: 85.0% BP vs. 6.7% ADHD). In the BP group, 55.0% had grandiose delusions, 26.7% had suicidality with plan/intent and 83.3% were rapid, ultra-rapid or ultradian cyclers. LIMITATIONS: Sites for consecutive case ascertainment from the lowest socioeconomic status classes were unavailable due to current health care policies. CLINICAL RELEVANCE: Prepubertal and early adolescent BP cases differentiate from ADHD by mania-specific criteria and commonly present with ultra-rapid or ultradian cycling.
BACKGROUND: In contrast to differential diagnosis (ddx) of older adolescent and adult bipolarity (BP), which includes schizophrenia and substance use disorders, the main ddx of prepubertal and early adolescent BP is attention-deficit disorder with hyperactivity (ADHD). To address this ddx issue, and to provide prepubertal mania manifestations, interim baseline data are presented from the National Institute of Mental Health (NIMH)-funded study 'Phenomenology and Course of Pediatric Bipolarity'. METHODS: Data are from the first 60 BP and the first 60 ADHD cases from 270 consecutively ascertained subjects (90 BP, 90 ADHD and 90 community controls). Comprehensive assessments included the Washington University at St. Louis Kiddie and Young Adult-Schedule for Affective Disorders and Schizophrenia--Lifetime and Present Episode Version-DSM-IV (WASH-U-KSADS) blindly administered by nurses to mothers about their offspring and to children/adolescents about themselves. Caseness was established by consensus conferences that included diagnostic and impairment data, teacher and school reports, agency records, videotapes and medical charts. RESULTS: Mean baseline age of BP cases was 11.0+/-2.7 years and the mean age at onset of BP was 8.1+/-3.5 years. Elated mood, grandiosity, hypersexuality, decreased need for sleep, racing thoughts and all other mania items except hyperenergetic and distractibility were significantly and substantially more frequent among BP than ADHD cases (e.g., elation: 86.7% BP vs. 5.0% ADHD; grandiosity: 85.0% BP vs. 6.7% ADHD). In the BP group, 55.0% had grandiose delusions, 26.7% had suicidality with plan/intent and 83.3% were rapid, ultra-rapid or ultradian cyclers. LIMITATIONS: Sites for consecutive case ascertainment from the lowest socioeconomic status classes were unavailable due to current health care policies. CLINICAL RELEVANCE: Prepubertal and early adolescent BP cases differentiate from ADHD by mania-specific criteria and commonly present with ultra-rapid or ultradian cycling.
Authors: Sarah McCue Horwitz; Christine A Demeter; Maria E Pagano; Eric A Youngstrom; Mary A Fristad; L Eugene Arnold; Boris Birmaher; Mary Kay Gill; David Axelson; Robert A Kowatch; Thomas W Frazier; Robert L Findling Journal: J Clin Psychiatry Date: 2010-10-05 Impact factor: 4.384
Authors: Garrett M Sparks; David A Axelson; Haifeng Yu; Wonho Ha; Javier Ballester; Rasim S Diler; Benjamin Goldstein; Tina Goldstein; Mary Beth Hickey; Cecile D Ladouceur; Kelly Monk; Dara Sakolsky; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-01-26 Impact factor: 8.829
Authors: Daniel P Dickstein; Elizabeth C Finger; Martha Skup; Daniel S Pine; James R Blair; Ellen Leibenluft Journal: Bipolar Disord Date: 2010-11 Impact factor: 6.744
Authors: Daniel P Dickstein; Kenneth E Towbin; Jan Willem Van Der Veen; Brendan A Rich; Melissa A Brotman; Lisa Knopf; Laura Onelio; Daniel S Pine; Ellen Leibenluft Journal: J Child Adolesc Psychopharmacol Date: 2009-02 Impact factor: 2.576
Authors: Daniel P Dickstein; Brendan A Rich; Roxann Roberson-Nay; Lisa Berghorst; Deborah Vinton; Daniel S Pine; Ellen Leibenluft Journal: Bipolar Disord Date: 2007-11 Impact factor: 6.744
Authors: Eric A Youngstrom; Thomas W Frazier; Christine Demeter; Joseph R Calabrese; Robert L Findling Journal: J Clin Psychiatry Date: 2008-05 Impact factor: 4.384