Research article summary (published 29 Sep 2006):

Phenomenology of children and adolescents with bipolar spectrum disorders.

Full Abstract

CONTEXT: Children and adolescents who present with manic symptoms frequently do not meet the full DSM-IV criteria for bipolar I disorder (BP-I). OBJECTIVE: To assess the clinical presentation and family history of children and adolescents with BP-I, bipolar II disorder (BP-II), and bipolar disorder not otherwise specified (BP-NOS). DESIGN: Subjects and their primary caretaker were assessed by semistructured interview, and family psychiatric history was obtained from interview of the primary caretaker. SETTING: Outpatient and inpatient units at 3 university centers. PARTICIPANTS: A total of 438 children and adolescents (mean +/- SD age, 12.7 +/- 3.2 years) with BP-I (n = 255), BP-II (n = 30), or BP-NOS (n = 153). MAIN OUTCOME MEASURES: Lifetime psychiatric history and family history of psychiatric disorders. RESULTS: Youth with BP-NOS were not diagnosed as having BP-I primarily because they did not meet the DSM-IV duration criteria for a manic or mixed episode. There were no significant differences among the BP-I and BP-NOS groups in age of onset, duration of illness, lifetime rates of comorbid diagnoses, suicidal ideation and major depression, family history, and the types of manic symptoms that were present during the most serious lifetime episode. Compared with youth with BP-NOS, subjects with BP-I had more severe manic symptoms, greater overall functional impairment, and higher rates of hospitalization, psychosis, and suicide attempts. Elevated mood was present in 81.9% of subjects with BP-NOS and 91.8% of subjects with BP-I. Subjects with BP-II had higher rates of comorbid anxiety disorders compared with the other 2 groups and had less functional impairment and lower rates of psychiatric hospitalization than the subjects with BP-I. CONCLUSIONS: Children and adolescents with BP-II and BP-NOS have a phenotype that is on a continuum with that of youth with BP-I. Elevated mood is a common feature of youth with BP-spectrum illness.

Author information

Author/s: Axelson, David (D); Birmaher, Boris (B); Strober, Michael (M); Gill, Mary Kay (MK); Valeri, Sylvia (S); Chiappetta, Laurel (L); Ryan, Neal (N); Leonard, Henrietta (H); Hunt, Jeffrey (J); Iyengar, Satish (S); Bridge, Jeffrey (J); Keller, Martin (M);

Affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA. alexsonda(-atsign-)upmc.edu

Grants: MH59691 (Agency:NIMH NIH HHS) ; MH59929 (Agency:NIMH NIH HHS) ; MH59977 (Agency:NIMH NIH HHS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural

Journal: Archives of general psychiatry (Arch Gen Psychiatry), published in United States. (Language: eng)

Reference: 2006-Oct; vol 63 (issue 10) : pp 1139-48

Dates: Created 2006/10/03; Completed 2006/11/06; Revised 2007/11/14;

PMID: 17015816, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent Age Factors Age of Onset Anxiety Disorders - diagnosis; epidemiology Bipolar Disorder - classification; diagnosis; epidemiology; psychology Child Comorbidity Depressive Disorder, Major - diagnosis; epidemiology Diagnosis, Differential Diagnostic and Statistical Manual of Mental Disorders Family Health

Family Health Female Hospitalization - statistics & numerical data Humans Male Medical History Taking Mental Disorders - diagnosis; epidemiology Phenotype Psychiatric Status Rating Scales Severity of Illness Index Suicide - psychology

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