 |
|
Phenomenology of Children and Adolescents With Bipolar Spectrum Disorders
David Axelson, MD;
Boris Birmaher, MD;
Michael Strober, PhD;
Mary Kay Gill, MSN;
Sylvia Valeri, PhD;
Laurel Chiappetta, MS;
Neal Ryan, MD;
Henrietta Leonard, MD;
Jeffrey Hunt, MD;
Satish Iyengar, PhD;
Jeffrey Bridge, PhD;
Martin Keller, MD
Arch Gen Psychiatry. 2006;63:1139-1148.
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 Affiliations: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center (Drs Axelson, Birmaher, Ryan, and Bridge and Mss Gill and Chiappetta), and Department of Statistics, University of Pittsburgh (Dr Iyengar), Pittsburgh, Pa; Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine at UCLA, Los Angeles, Calif (Dr Strober); and Department of Psychiatry and Butler Hospital, Brown University School of Medicine, Providence, RI (Drs Valeri, Leonard, Hunt, and Keller).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Four-Year Longitudinal Course of Children and Adolescents With Bipolar Spectrum Disorders: The Course and Outcome of Bipolar Youth (COBY) Study
Birmaher et al.
Am. J. Psychiatry 2009;166:795-804.
ABSTRACT
| FULL TEXT
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
Pediatric Bipolar Disorder Comes of Age
Leibenluft
Arch Gen Psychiatry 2008;65:1122-1124.
FULL TEXT
Child Bipolar I Disorder: Prospective Continuity With Adult Bipolar I Disorder; Characteristics of Second and Third Episodes; Predictors of 8-Year Outcome
Geller et al.
Arch Gen Psychiatry 2008;65:1125-1133.
ABSTRACT
| FULL TEXT
Family-Focused Treatment for Adolescents With Bipolar Disorder: Results of a 2-Year Randomized Trial
Miklowitz et al.
Arch Gen Psychiatry 2008;65:1053-1061.
ABSTRACT
| FULL TEXT
Pediatric Bipolar Disorder
Leibenluft and Rich
Focus 2008;6:331-347.
ABSTRACT
| FULL TEXT
National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth
Moreno et al.
Arch Gen Psychiatry 2007;64:1032-1039.
ABSTRACT
| FULL TEXT
The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder
Chang and Shah
JAMA 2007;298:96-97.
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
Longitudinal Course of Pediatric Bipolar Disorder
Birmaher
Am. J. Psychiatry 2007;164:537-539.
FULL TEXT
Different Psychophysiological and Behavioral Responses Elicited by Frustration in Pediatric Bipolar Disorder and Severe Mood Dysregulation
Rich et al.
Am. J. Psychiatry 2007;164:309-317.
ABSTRACT
| FULL TEXT
|
