OBJECTIVES: There are no established tools to identify individuals at risk for developing bipolar disorder. We developed a set of ultra-high-risk criteria for bipolar disorder [bipolar at-risk (BAR)]. The primary aim of the present study was to determine the predictive validity of the BAR criteria. METHODS: This was a 12-month prospective study that was conducted at Orygen Youth Health Clinical Program, a public mental health program for young people aged 15-24 years in metropolitan Melbourne, Australia. At intake, BAR screen-positive individuals and a matched group of individuals who did not meet BAR criteria were observed over a period of 12 months. The BAR criteria include general criteria such as being in the peak age range for the onset of the disorder, as well as sub-threshold mania, depression plus cyclothymic features, and depression plus genetic risk. Conversion to first-episode mania/hypomania was defined by the presence of DSM-IV manic symptoms for more than four days, in line with the DSM-IV definition of hypomania/mania. RESULTS: A total of 559 help-seeking patients were screened. Of the eligible participants, 59 (10.6%) met BAR criteria. Thirty-five participants were included in the BAR group and 35 matched participants were selected to be in the control group. During the follow-up, five BAR patients out of 35 (14.3%) converted to first-episode hypomania/mania as opposed to none in the non-BAR group [χ(2) (1) = 5.38, p = 0.020]. Four out of these five converters had a DSM-IV diagnosis of bipolar I or bipolar II disorder. CONCLUSIONS: These findings support the possibility of identification of persons prior to the onset of mania/hypomania. The proposed criteria need further evaluation in larger, prospective studies with longer follow-up periods.
OBJECTIVES: There are no established tools to identify individuals at risk for developing bipolar disorder. We developed a set of ultra-high-risk criteria for bipolar disorder [bipolar at-risk (BAR)]. The primary aim of the present study was to determine the predictive validity of the BAR criteria. METHODS: This was a 12-month prospective study that was conducted at Orygen Youth Health Clinical Program, a public mental health program for young people aged 15-24 years in metropolitan Melbourne, Australia. At intake, BAR screen-positive individuals and a matched group of individuals who did not meet BAR criteria were observed over a period of 12 months. The BAR criteria include general criteria such as being in the peak age range for the onset of the disorder, as well as sub-threshold mania, depression plus cyclothymic features, and depression plus genetic risk. Conversion to first-episode mania/hypomania was defined by the presence of DSM-IV manic symptoms for more than four days, in line with the DSM-IV definition of hypomania/mania. RESULTS: A total of 559 help-seeking patients were screened. Of the eligible participants, 59 (10.6%) met BAR criteria. Thirty-five participants were included in the BAR group and 35 matched participants were selected to be in the control group. During the follow-up, five BAR patients out of 35 (14.3%) converted to first-episode hypomania/mania as opposed to none in the non-BAR group [χ(2) (1) = 5.38, p = 0.020]. Four out of these five converters had a DSM-IV diagnosis of bipolar I or bipolar II disorder. CONCLUSIONS: These findings support the possibility of identification of persons prior to the onset of mania/hypomania. The proposed criteria need further evaluation in larger, prospective studies with longer follow-up periods.
Authors: Robert K McNamara; Jeffrey R Strawn; Max J Tallman; Jeffrey A Welge; L Rodrigo Patino; Thomas J Blom; Melissa P DelBello Journal: J Child Adolesc Psychopharmacol Date: 2020-03-11 Impact factor: 2.576
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Authors: Robert K McNamara; Ann B Moser; Richard I Jones; Ronald Jandacek; L Rodrigo Patino; Jeffrey R Strawn; Stephen M Strakowski; Melissa P DelBello Journal: Psychiatry Res Date: 2016-10-25 Impact factor: 3.222
Authors: Danella M Hafeman; John Merranko; David Axelson; Benjamin I Goldstein; Tina Goldstein; Kelly Monk; Mary Beth Hickey; Dara Sakolsky; Rasim Diler; Satish Iyengar; David Brent; David Kupfer; Boris Birmaher Journal: Am J Psychiatry Date: 2016-02-19 Impact factor: 18.112
Authors: Christoph U Correll; Doreen M Olvet; Andrea M Auther; Marta Hauser; Taishiro Kishimoto; Ricardo E Carrión; Stephanie Snyder; Barbara A Cornblatt Journal: Bipolar Disord Date: 2014-05-08 Impact factor: 6.744
Authors: Gustavo Scola; Robert K McNamara; Paul E Croarkin; Jarrod M Leffler; Kathryn R Cullen; Jennifer R Geske; Joanna M Biernacka; Mark A Frye; Melissa P DelBello; Ana C Andreazza Journal: J Affect Disord Date: 2015-12-23 Impact factor: 4.839