Danella M Hafeman1, Tina R Goldstein1, Michael Strober2, John Merranko1, Mary Kay Gill1, Fangzi Liao1, Rasim S Diler1, Neal D Ryan1, Benjamin I Goldstein3, David A Axelson4, Martin B Keller5,6, Jeffrey I Hunt5,7, Heather Hower5,8,9, Lauren M Weinstock5,6, Shirley Yen5,10, Boris Birmaher1. 1. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 2. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. 3. Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, ON, Canada. 4. Department of Psychiatry, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, OH, USA. 5. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA. 6. Butler Hospital, Providence, RI, USA. 7. Bradley Hospital, East Providence, RI, USA. 8. Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA. 9. Department of Psychiatry, School of Medicine, University of California San Diego, San Diego, CA, USA. 10. Beth Israel Deaconess Medical Center, Boston, MA, USA.
Abstract
OBJECTIVES: While adults with bipolar disorder (BD) often report symptoms starting in childhood, continuity of mania and/or hypomania (mania/hypomania) from childhood to adulthood has been questioned. Using longitudinal data from the Course and Outcome of Bipolar Youth (COBY) study, we assessed threshold mania/hypomania in young adults who manifested BD as youth. METHODS: COBY is a naturalistic, longitudinal study of 446 youth with BD (84% recruited from outpatient clinics), 7-17 years old at intake, and over 11 years of follow-up. Focusing on youth with BD-I/II (n = 297), we examined adult mania/hypomania risk (>18 years old; mean 7.9 years of follow-up) according to child (<13 years old) versus adolescent (13-17 years old) onset. We next used penalized regression to test demographic and clinical predictors of young adult mania/hypomania. RESULTS: Most participants (64%) had child-onset mania/hypomania, 57% of whom also experienced mania/hypomania in adolescence. Among those who experienced an episode in adolescence, over 40% also had mania/hypomania during adulthood; the risk did not differ according to child versus adolescent onset. In contrast, 7% with mania/hypomania in childhood, but not adolescence, experienced mania/hypomania in adulthood. Family history (of mania and suicide attempts) predicted mania/hypomania in young adulthood (p-values <0.05); age of onset was not a significant predictor. Among participants with no mania/hypomania during adulthood, 53% (105/198) still experienced subthreshold manic episodes. DISCUSSION: We find substantial continuity across developmental stage indicating that, in this carefully characterized sample, children who experience mania/hypomania-particularly those who also experience mania/hypomania in adolescence-are likely to experience mania/hypomania in young adulthood.
OBJECTIVES: While adults with bipolar disorder (BD) often report symptoms starting in childhood, continuity of mania and/or hypomania (mania/hypomania) from childhood to adulthood has been questioned. Using longitudinal data from the Course and Outcome of Bipolar Youth (COBY) study, we assessed threshold mania/hypomania in young adults who manifested BD as youth. METHODS: COBY is a naturalistic, longitudinal study of 446 youth with BD (84% recruited from outpatient clinics), 7-17 years old at intake, and over 11 years of follow-up. Focusing on youth with BD-I/II (n = 297), we examined adult mania/hypomania risk (>18 years old; mean 7.9 years of follow-up) according to child (<13 years old) versus adolescent (13-17 years old) onset. We next used penalized regression to test demographic and clinical predictors of young adult mania/hypomania. RESULTS: Most participants (64%) had child-onset mania/hypomania, 57% of whom also experienced mania/hypomania in adolescence. Among those who experienced an episode in adolescence, over 40% also had mania/hypomania during adulthood; the risk did not differ according to child versus adolescent onset. In contrast, 7% with mania/hypomania in childhood, but not adolescence, experienced mania/hypomania in adulthood. Family history (of mania and suicide attempts) predicted mania/hypomania in young adulthood (p-values <0.05); age of onset was not a significant predictor. Among participants with no mania/hypomania during adulthood, 53% (105/198) still experienced subthreshold manic episodes. DISCUSSION: We find substantial continuity across developmental stage indicating that, in this carefully characterized sample, children who experience mania/hypomania-particularly those who also experience mania/hypomania in adolescence-are likely to experience mania/hypomania in young adulthood.
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: 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: Carrie A H Vaudreuil; Stephen V Faraone; Maura Di Salvo; Janet R Wozniak; Rebecca A Wolenski; Nicholas W Carrellas; Joseph Biederman Journal: Bipolar Disord Date: 2018-12-19 Impact factor: 6.744
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: Boris Birmaher; John A Merranko; Mary Kay Gill; Danella Hafeman; Tina Goldstein; Benjamin Goldstein; Heather Hower; Michael Strober; David Axelson; Neal Ryan; Shirley Yen; Rasim Diler; Satish Iyengar; Michael W Kattan; Lauren Weinstock; Martin Keller Journal: J Am Acad Child Adolesc Psychiatry Date: 2020-01-21 Impact factor: 8.829
Authors: Manpreet K Singh; Robert M Post; David J Miklowitz; Boris Birmaher; Eric Youngstrom; Benjamin Goldstein; Cesar Soutullo; David Axelson; Kiki D Chang; Melissa P DelBello Journal: Bipolar Disord Date: 2021-10-29 Impact factor: 6.744