Bipolar Disorder in Children Appears Likely to Continue Into Young Adulthood

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Title: Bipolar Disorder in Children Appears Likely to Continue Into Young Adulthood
URL: http://www.pslgroup.com/dg/22E406.htm
Doctor's Guide
October 6, 2008

CHICAGO -- October 6, 2008 -- About 44% of individuals who had bipolar disorder as children continue to have manic episodes as young adults, according to a report in the October issue of Archives of General Psychiatry.

This rate, along with the severity of the disease at young ages, strongly suggests that bipolar disorder can be continuous from childhood to adulthood, the authors noted.

Recent data have demonstrated an enormous increase in the diagnosis of paediatric bipolar disorder. However, scepticism continues to exist regarding the existence of the condition in children.

Barbara Geller, MD, Washington University, St. Louis, Missouri, and colleagues studied 115 children (mean age 11.1 y) diagnosed with bipolar disorder from 1995 to 1998. At the beginning of the study and again during 9 follow-up visits conducted over 8 years, the children and their parents were interviewed separately about their symptoms, diagnoses, daily cycles of mania and depression, and interactions with others.

A total of 108 (93.9%) of the children completed the study (mean age at follow-up, 18.1 y). During the 8-year follow-up, they spent 60.2% of weeks with any mood episodes and 39.6% of weeks with episodes of mania. Although 87.8% recovered from mania, 73.3% relapsed.

The researchers also examined the characteristics of children's second and third episodes of mania and found that like the first episodes, they were characterised by psychosis, daily cycling between mania and depression, and a long duration (55.2 weeks for the second and 40 weeks for the third episode).

At the end of the follow-up period, 54 patients were aged 18 years or older. Of those, 44.4% continued to have manic episodes and 35.2% had substance-use disorders, a rate similar to those diagnosed with bipolar disorder as adults.

"In grown-up subjects with child bipolar disorder I, the 44.4% frequency of manic episodes was 13 to 44 times higher than population prevalences, strongly supporting continuity between child and adult bipolar disorder I," the authors wrote.

"Subjects with child bipolar disorder I who were grown up at the 8-year follow-up constituted approximately half the sample. However, even if all subjects younger than 18 years at the 8-year follow-up never had episodes of bipolar disorder I as adults, the overall significance of the findings would be similar, because the rate would still be 6 to 22 times higher than population prevalences."

"In conclusion, mounting data support the existence of child bipolar disorder I, and the severity and chronicity of this disorder argue strongly for large efforts toward understanding the neurobiology and for developing prevention and intervention strategies," the authors concluded.

SOURCE: Archives of General Psychiatry

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