BACKGROUND: The strengths and limitations of considering childhood-and adolescent-onset bipolar disorder (BD) separately versus together remain to be established. We assessed this issue. METHODS: BD patients referred to the Stanford Bipolar Disorder Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD Affective Disorders Evaluation. Patients with childhood- and adolescent-onset were compared to those with adult-onset for 7 unfavorable bipolar illness characteristics with replicated associations with early-onset patients. RESULTS: Among 502 BD outpatients, those with childhood- (<13 years, N=110) and adolescent- (13-18 years, N=218) onset had significantly higher rates for 4/7 unfavorable illness characteristics, including lifetime comorbid anxiety disorder, at least ten lifetime mood episodes, lifetime alcohol use disorder, and prior suicide attempt, than those with adult-onset (>18 years, N=174). Childhood- but not adolescent-onset BD patients also had significantly higher rates of first-degree relative with mood disorder, lifetime substance use disorder, and rapid cycling in the prior year. Patients with pooled childhood/adolescent - compared to adult-onset had significantly higher rates for 5/7 of these unfavorable illness characteristics, while patients with childhood- compared to adolescent-onset had significantly higher rates for 4/7 of these unfavorable illness characteristics. LIMITATIONS: Caucasian, insured, suburban, low substance abuse, American specialty clinic-referred sample limits generalizability. Onset age is based on retrospective recall. CONCLUSIONS: Childhood- compared to adolescent-onset BD was more robustly related to unfavorable bipolar illness characteristics, so pooling these groups attenuated such relationships. Further study is warranted to determine the extent to which adolescent-onset BD represents an intermediate phenotype between childhood- and adult-onset BD.
BACKGROUND: The strengths and limitations of considering childhood-and adolescent-onset bipolar disorder (BD) separately versus together remain to be established. We assessed this issue. METHODS: BD patients referred to the Stanford Bipolar Disorder Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD Affective Disorders Evaluation. Patients with childhood- and adolescent-onset were compared to those with adult-onset for 7 unfavorable bipolar illness characteristics with replicated associations with early-onset patients. RESULTS: Among 502 BD outpatients, those with childhood- (<13 years, N=110) and adolescent- (13-18 years, N=218) onset had significantly higher rates for 4/7 unfavorable illness characteristics, including lifetime comorbid anxiety disorder, at least ten lifetime mood episodes, lifetime alcohol use disorder, and prior suicide attempt, than those with adult-onset (>18 years, N=174). Childhood- but not adolescent-onset BD patients also had significantly higher rates of first-degree relative with mood disorder, lifetime substance use disorder, and rapid cycling in the prior year. Patients with pooled childhood/adolescent - compared to adult-onset had significantly higher rates for 5/7 of these unfavorable illness characteristics, while patients with childhood- compared to adolescent-onset had significantly higher rates for 4/7 of these unfavorable illness characteristics. LIMITATIONS: Caucasian, insured, suburban, low substance abuse, American specialty clinic-referred sample limits generalizability. Onset age is based on retrospective recall. CONCLUSIONS: Childhood- compared to adolescent-onset BD was more robustly related to unfavorable bipolar illness characteristics, so pooling these groups attenuated such relationships. Further study is warranted to determine the extent to which adolescent-onset BD represents an intermediate phenotype between childhood- and adult-onset BD.
Authors: A Carlo Altamura; Massimiliano Buoli; Bruno Cesana; Bernardo Dell'Osso; Gianluigi Tacchini; Umberto Albert; Andrea Fagiolini; Andrea de Bartolomeis; Giuseppe Maina; Emilio Sacchetti Journal: Eur Arch Psychiatry Clin Neurosci Date: 2017-04-01 Impact factor: 5.270
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Authors: Danielle R Balzafiore; Natalie L Rasgon; Laura D Yuen; Saloni Shah; Hyun Kim; Kathryn C Goffin; Shefali Miller; Po W Wang; Terence A Ketter Journal: Int J Bipolar Disord Date: 2017-08-12
Authors: Sorcha Bolton; Dan W Joyce; Katherine Gordon-Smith; Lisa Jones; Ian Jones; John Geddes; Kate E A Saunders Journal: BJPsych Open Date: 2022-07-18
Authors: Flórido Sampaio das Neves Peixoto; Danilo Ferreira de Sousa; Dayse Christina Rodrigues Pereira Luz; Nélio Barreto Vieira; Jucier Gonçalves Júnior; Gabriel Cabral Alencar Dos Santos; Flaviane Cristine Troglio da Silva; Modesto Leite Rolim Neto Journal: Ann Gen Psychiatry Date: 2017-04-21 Impact factor: 3.455