BACKGROUND: This study on a large sample of unselected, consecutive children and adolescents referred to a third-level hospital who received a diagnosis of bipolar disorder (BD) was aimed at exploring whether childhood-onset BD, as compared with adolescent-onset BD, presents specific clinical features in terms of severity, functional impairment, course, prevalent mood, pattern of co-morbidity, and treatment outcome. METHODS: A total of 136 patients, 81 males (59.6%) and 55 females (40.4%), mean age 13.5 +/- 2.9 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of BD according to a structured clinical interview Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL), were included in the study. RESULTS: Eighty patients (58.8%) had a childhood-onset BD (before 12 years of age) and 56 (41.2%) had an adolescents-onset BD. Compared with the adolescent-onset BD, patients with childhood-onset were more frequently males and had a more frequent co-morbidity with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). An episodic course was found in only 42.5% of bipolar children, but 76.8% of youngsters with adolescent-onset BD. Severity, 6-month treatment outcome, prevalent mood (elated versus irritable), and co-morbid anxiety did not differentiate the two groups. CONCLUSIONS: Our findings suggest that a very early age at onset may identify a form of BD with a more frequent subcontinuous course and a heavy co-morbidity with ADHD.
BACKGROUND: This study on a large sample of unselected, consecutive children and adolescents referred to a third-level hospital who received a diagnosis of bipolar disorder (BD) was aimed at exploring whether childhood-onset BD, as compared with adolescent-onset BD, presents specific clinical features in terms of severity, functional impairment, course, prevalent mood, pattern of co-morbidity, and treatment outcome. METHODS: A total of 136 patients, 81 males (59.6%) and 55 females (40.4%), mean age 13.5 +/- 2.9 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of BD according to a structured clinical interview Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL), were included in the study. RESULTS: Eighty patients (58.8%) had a childhood-onset BD (before 12 years of age) and 56 (41.2%) had an adolescents-onset BD. Compared with the adolescent-onset BD, patients with childhood-onset were more frequently males and had a more frequent co-morbidity with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). An episodic course was found in only 42.5% of bipolar children, but 76.8% of youngsters with adolescent-onset BD. Severity, 6-month treatment outcome, prevalent mood (elated versus irritable), and co-morbid anxiety did not differentiate the two groups. CONCLUSIONS: Our findings suggest that a very early age at onset may identify a form of BD with a more frequent subcontinuous course and a heavy co-morbidity with ADHD.
Authors: Carrie E Bearden; Jair C Soares; Andrea D Klunder; Mark Nicoletti; Nicole Dierschke; Kiralee M Hayashi; Katherine L Narr; Paolo Brambilla; Roberto B Sassi; David Axelson; Neal Ryan; Boris Birmaher; Paul M Thompson Journal: J Am Acad Child Adolesc Psychiatry Date: 2008-05 Impact factor: 8.829
Authors: Robert L Findling; L Eugene Arnold; Laurence L Greenhill; Christopher J Kratochvil; James J McGough Journal: Prim Care Companion J Clin Psychiatry Date: 2008
Authors: Boris Birmaher; David Axelson; Michael Strober; Mary Kay Gill; Mei Yang; Neal Ryan; Benjamin Goldstein; Jeffrey Hunt; Christianne Esposito-Smythers; Satish Iyengar; Tina Goldstein; Laurel Chiapetta; Martin Keller; Henrietta Leonard Journal: Bipolar Disord Date: 2009-02 Impact factor: 6.744
Authors: Argelinda Baroni; Jessica R Lunsford; David A Luckenbaugh; Kenneth E Towbin; Ellen Leibenluft Journal: J Child Psychol Psychiatry Date: 2009-03 Impact factor: 8.982