OBJECTIVE: The authors sought to assess dimensional symptomatic predictors of new-onset bipolar spectrum disorders in youths at familial risk of bipolar disorder ("at-risk" youths). METHOD: Offspring 6-18 years old of parents with bipolar I or II disorder (N=359) and community comparison offspring (N=220) were recruited. At baseline, 8.4% of the offspring of bipolar parents had a bipolar spectrum disorder. Over 8 years, 14.7% of offspring for whom follow-up data were available (44/299) developed a new-onset bipolar spectrum disorder (15 with bipolar I or II disorder). Measures collected at baseline and follow-up were reduced using factor analyses, and factors (both at baseline and at the visit prior to conversion or last contact) were assessed as predictors of new-onset bipolar spectrum disorders. RESULTS: Relative to comparison offspring, at-risk and bipolar offspring had higher baseline levels of anxiety/depression, inattention/disinhibition, externalizing, subsyndromal manic, and affective lability symptoms. The strongest predictors of new-onset bipolar spectrum disorders were baseline anxiety/depression, baseline and proximal affective lability, and proximal subsyndromal manic symptoms (p<0.05). While affective lability and anxiety/depression were elevated throughout follow-up in those who later developed a bipolar spectrum disorder, manic symptoms increased up to the point of conversion. A path analysis supported the hypothesis that affective lability at baseline predicts a new-onset bipolar spectrum disorder in part through increased manic symptoms at the visit prior to conversion; earlier parental age at mood disorder onset was also significantly associated with an increased risk of conversion. While youths without anxiety/depression, affective lability, and mania (and with a parent with older age at mood disorder onset) had a 2% predicted chance of conversion to a bipolar spectrum disorder, those with all risk factors had a 49% predicted chance of conversion. CONCLUSIONS: Dimensional measures of anxiety/depression, affective lability, and mania are important predictors of new-onset bipolar spectrum disorders in at-risk youths. These symptoms emerged from among numerous other candidates, underscoring the potential clinical and research utility of these findings.
OBJECTIVE: The authors sought to assess dimensional symptomatic predictors of new-onset bipolar spectrum disorders in youths at familial risk of bipolar disorder ("at-risk" youths). METHOD: Offspring 6-18 years old of parents with bipolar I or II disorder (N=359) and community comparison offspring (N=220) were recruited. At baseline, 8.4% of the offspring of bipolar parents had a bipolar spectrum disorder. Over 8 years, 14.7% of offspring for whom follow-up data were available (44/299) developed a new-onset bipolar spectrum disorder (15 with bipolar I or II disorder). Measures collected at baseline and follow-up were reduced using factor analyses, and factors (both at baseline and at the visit prior to conversion or last contact) were assessed as predictors of new-onset bipolar spectrum disorders. RESULTS: Relative to comparison offspring, at-risk and bipolar offspring had higher baseline levels of anxiety/depression, inattention/disinhibition, externalizing, subsyndromal manic, and affective lability symptoms. The strongest predictors of new-onset bipolar spectrum disorders were baseline anxiety/depression, baseline and proximal affective lability, and proximal subsyndromal manic symptoms (p<0.05). While affective lability and anxiety/depression were elevated throughout follow-up in those who later developed a bipolar spectrum disorder, manic symptoms increased up to the point of conversion. A path analysis supported the hypothesis that affective lability at baseline predicts a new-onset bipolar spectrum disorder in part through increased manic symptoms at the visit prior to conversion; earlier parental age at mood disorder onset was also significantly associated with an increased risk of conversion. While youths without anxiety/depression, affective lability, and mania (and with a parent with older age at mood disorder onset) had a 2% predicted chance of conversion to a bipolar spectrum disorder, those with all risk factors had a 49% predicted chance of conversion. CONCLUSIONS: Dimensional measures of anxiety/depression, affective lability, and mania are important predictors of new-onset bipolar spectrum disorders in at-risk youths. These symptoms emerged from among numerous other candidates, underscoring the potential clinical and research utility of these findings.
Authors: Lauren E Lombardo; Carrie E Bearden; Jennifer Barrett; Margaret S Brumbaugh; Brian Pittman; Sophia Frangou; David C Glahn Journal: Bipolar Disord Date: 2012-07-16 Impact factor: 6.744
Authors: M Wals; M H Hillegers; C G Reichart; J Ormel; W A Nolen; F C Verhulst Journal: J Am Acad Child Adolesc Psychiatry Date: 2001-09 Impact factor: 8.829
Authors: David A Axelson; Boris Birmaher; Michael A Strober; Benjamin I Goldstein; Wonho Ha; Mary Kay Gill; Tina R Goldstein; Shirley Yen; Heather Hower; Jeffrey I Hunt; Fangzi Liao; Satish Iyengar; Daniel Dickstein; Eunice Kim; Neal D Ryan; Erica Frankel; Martin B Keller Journal: J Am Acad Child Adolesc Psychiatry Date: 2011-09-08 Impact factor: 8.829
Authors: Benjamin I Goldstein; Wael Shamseddeen; David A Axelson; Cathy Kalas; Kelly Monk; David A Brent; David J Kupfer; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2010-04 Impact factor: 8.829
Authors: Esther Mesman; Willem A Nolen; Catrien G Reichart; Marjolein Wals; Manon H J Hillegers Journal: Am J Psychiatry Date: 2013-05 Impact factor: 18.112
Authors: Boris Birmaher; Benjamin I Goldstein; David A Axelson; Kelly Monk; Mary Beth Hickey; Jieyu Fan; Satish Iyengar; Wonho Ha; Rasim S Diler; Tina Goldstein; David Brent; Cecile D Ladouceur; Dara Sakolsky; David J Kupfer Journal: Bipolar Disord Date: 2013-04-03 Impact factor: 6.744
Authors: David J Miklowitz; Christopher D Schneck; Patricia D Walshaw; Amy S Garrett; Manpreet K Singh; Catherine A Sugar; Kiki D Chang Journal: Early Interv Psychiatry Date: 2017-08-04 Impact factor: 2.732
Authors: Rasim Somer Diler; Tina R Goldstein; Danella Hafeman; Brian Thomas Rooks; Dara Sakolsky; Benjamin I Goldstein; Kelly Monk; Mary Beth Hickey; David Axelson; Satish Iyengar; Boris Birmaher Journal: Bipolar Disord Date: 2017-06-14 Impact factor: 6.744
Authors: A Versace; C D Ladouceur; S Graur; H E Acuff; L K Bonar; K Monk; A McCaffrey; A Yendiki; A Leemans; M J Travis; V A Diwadkar; S K Holland; J L Sunshine; R A Kowatch; S M Horwitz; T W Frazier; L E Arnold; M A Fristad; E A Youngstrom; R L Findling; B I Goldstein; T Goldstein; D Axelson; B Birmaher; M L Phillips Journal: Neuropsychopharmacology Date: 2018-05-04 Impact factor: 7.853
Authors: Christopher D Schneck; Kiki D Chang; Manpreet K Singh; Melissa P DelBello; David J Miklowitz Journal: J Child Adolesc Psychopharmacol Date: 2017-07-21 Impact factor: 2.576
Authors: Jessica C Levenson; Adriane Soehner; Brian Rooks; Tina R Goldstein; Rasim Diler; John Merranko; David Axelson; Ben I Goldstein; David A Brent; Danella Hafeman; Mary Beth Hickey; Kelly Monk; Dara Sakolsky; David J Kupfer; Boris Birmaher Journal: J Affect Disord Date: 2017-03-06 Impact factor: 4.839
Authors: Boris Birmaher; John A Merranko; Tina R Goldstein; Mary Kay Gill; Benjamin I Goldstein; Heather Hower; Shirley Yen; Danella Hafeman; Michael Strober; Rasim S Diler; David Axelson; Neal D Ryan; Martin B Keller Journal: J Am Acad Child Adolesc Psychiatry Date: 2018-08-07 Impact factor: 8.829
Authors: Lisa A O'Donnell; Alissa J Ellis; Margaret M Van de Loo; Jonathan P Stange; David A Axelson; Robert A Kowatch; Christopher D Schneck; David J Miklowitz Journal: J Affect Disord Date: 2018-04-09 Impact factor: 4.839