This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Clinical, Genetic, and Psychopharmacologic Predictors in a Three-to Four-Year Prospective Follow-up Investigation

Michael Strober, PhD; Gabrielle Carlson, MD

Arch Gen Psychiatry. 1982;39(5):549-555.

Abstract
• Sixty adolescents, aged 13 to 16 years, hospitalized for major depression were studied prospectively for three to four years to determine the utility of clinical, genetic, and pharmacologic response variables in predicting a bipolar course of illness. Bipolar outcome was observed in 20% of the cohort. Statistical analyses showed that bipolarity was predicted by (1) a depressive symptom cluster comprising rapid symptom onset, psychomotor retardation, and mood-congruent psychotic features; (2) a "loading" of affective disorder in the family pedigree, a family history of bipolar illness, and the presence of illness in three successive generations of the pedigree; and (3) pharmacologically induced hypomania. All predictors were shown to have high specificity for bipolar outcome, whereas pharmacologic hypomania and symptom cluster permitted the highest confidence of prediction, 100% and 80%, respectively. Even in juvenile depression, careful attention to clinical and biologic variables may aid in the predictive differentiation of meaningful diagnostic subtypes.

Author Affiliations
From the Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, UCLA Center for the Health Sciences, Los Angeles.

Footnotes
Accepted for publication Oct 27, 1981.

Reprint requests to Neuropsychiatric Institute, UCLA Center for the Health Sciences, 760 Westwood Plaza, Los Angeles, CA 90024 (Dr Strober).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lifetime Psychiatric Disorders in School-aged Offspring of Parents With Bipolar Disorder: The Pittsburgh Bipolar Offspring Study
Birmaher et al.
Arch Gen Psychiatry 2009;66:287-296.
ABSTRACT | FULL TEXT  

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Depressive Disorders
Focus 2008;6:379-400.
ABSTRACT | FULL TEXT  

Olanzapine Versus Placebo in the Treatment of Adolescents With Bipolar Mania
Tohen et al.
Am. J. Psychiatry 2007;164:1547-1556.
ABSTRACT | FULL TEXT  

Current Issues in the Classification of Psychotic Major Depression
Keller et al.
Schizophr Bull 2007;33:877-885.
ABSTRACT | FULL TEXT  

Differentiation in the Preonset Phases of Schizophrenia and Mood Disorders: Evidence in Support of a Bipolar Mania Prodrome
Correll et al.
Schizophr Bull 2007;0:sbm028v1-1.
ABSTRACT | FULL TEXT  

Mania and Attention Deficit Hyperactivity Disorder in a Prepubertal Child: Diagnostic and Treatment Challenges
State et al.
Am. J. Psychiatry 2002;159:918-925.
FULL TEXT  

The Maudsley long-term follow-up of child and adolescent depression: 1. Psychiatric outcomes in adulthood
FOMBONNE et al.
Br. J. Psychiatry 2001;179:210-217.
ABSTRACT | FULL TEXT  

Risk for Bipolar Illness in Patients Initially Hospitalized for Unipolar Depression
Goldberg et al.
Am. J. Psychiatry 2001;158:1265-1270.
ABSTRACT | FULL TEXT  

The search for the wandering thymostat: a review of some developments in bipolar disorder research
FERRIER et al.
Br. J. Psychiatry 2001;178 :s103-s106.
FULL TEXT  

A Controlled Family History Study of Childhood-Onset Depressive Disorder
Kovacs et al.
Arch Gen Psychiatry 1997;54:613-623.
ABSTRACT  

Nocturnal Serum Melatonin Profile in Major Depression in Children and Adolescents
Shafii et al.
Arch Gen Psychiatry 1996;53:1009-1013.
ABSTRACT  

Switching From 'Unipolar' to Bipolar II: An 11-Year Prospective Study of Clinical and Temperamental Predictors in 559 Patients
Akiskal et al.
Arch Gen Psychiatry 1995;52:114-123.
ABSTRACT  

Adult Outcomes of Childhood and Adolescent Depression: I. Psychiatric Status
Harrington et al.
Arch Gen Psychiatry 1990;47:465-473.
ABSTRACT  

Cortisol Secretion in Prepubertal Children With Major Depressive Disorder: Episode and Recovery
Puig-Antich et al.
Arch Gen Psychiatry 1989;46:801-809.
ABSTRACT  

A Controlled Family History Study of Prepubertal Major Depressive Disorder
Puig-Antich et al.
Arch Gen Psychiatry 1989;46:406-418.
ABSTRACT  

Use of Antidepressants in Bulimia
Walsh
CLIN PEDIATR 1989;28:127-128.
 

The Bi-Polar Prepubescent Adolescent: A Literature Review and Clinical Case Study of an Eleven-Year-Old Black Female
Grubb
Journal of Black Psychology 1989;15:129-147.
ABSTRACT  

Neuropsychiatry Evaluation and Treatment of Children with Head Injury
McGuire and Sylvester
J Learn Disabil 1987;20:590-595.
ABSTRACT  

Children of Depressed Parents: Increased Psychopathology and Early Onset of Major Depression
Weissman et al.
Arch Gen Psychiatry 1987;44:847-853.
ABSTRACT  

The Clinical Picture of Major Depression in Children and Adolescents
Ryan et al.
Arch Gen Psychiatry 1987;44:854-861.
ABSTRACT  

Electroencephalographic Sleep of Adolescents With Major Depression and Normal Controls
Goetz et al.
Arch Gen Psychiatry 1987;44:61-68.
ABSTRACT  

Family-Genetic Studies of Psychiatric Disorders: Developing Technologies
Weissman et al.
Arch Gen Psychiatry 1986;43:1104-1116.
ABSTRACT  

Adult Sequelae of Adolescent Depressive Symptoms
Kandel and Davies
Arch Gen Psychiatry 1986;43:255-262.
ABSTRACT  

Affective Disorders in Referred Children and Younger Siblings of Manic-Depressives: Mode of Onset and Prospective Course
Akiskal et al.
Arch Gen Psychiatry 1985;42:996-1003.
ABSTRACT  

Onset of Major Depression in Early Adulthood: Increased Familial Loading and Specificity
Weissman et al.
Arch Gen Psychiatry 1984;41:1136-1143.
ABSTRACT  

Depressive Disorders in Childhood: II. A Longitudinal Study of the Risk for a Subsequent Major Depression
Kovacs et al.
Arch Gen Psychiatry 1984;41:643-649.
ABSTRACT