Comparison of manic and depressive symptoms between children and adolescents with bipolar spectrum disorders
Open Access
- 9 January 2009
- journal article
- research article
- Published by Wiley in Bipolar Disorders
- Vol. 11 (1), 52-62
- https://doi.org/10.1111/j.1399-5618.2008.00659.x
Abstract
Objective: To compare the most severe lifetime (current or past) mood symptoms, duration of illness, and rates of lifetime comorbid disorders among youth with bipolar spectrum disorders [BP (bipolar‐I, bipolar‐II and bipolar–not otherwise specified)]. Methods: A total of 173 children (<12 years) with BP, 101 adolescents with childhood‐onset BP, and 90 adolescents with adolescent‐onset BP were evaluated with standardized instruments. Results: Depression was the most common initial and frequent episode for both adolescent groups, followed by mania/hypomania. Adolescents with childhood‐onset BP had the longest illness, followed by children and then adolescents with adolescent‐onset BP. Adjusting for sex, socioeconomic status, and duration of illness, while manic, both adolescent groups showed more ‘typical’ and severe manic symptoms. Mood lability was more frequent in childhood‐onset and adolescents with early‐onset BP. While depressed, both adolescent groups showed more severe depressive symptoms, higher rates of melancholic and atypical symptoms, and suicide attempts than children. Depressed children had more severe irritability than depressed adolescents. Early BP onset was associated with attention‐deficit hyperactivity disorder, whereas later BP onset was associated with panic, conduct, and substance use disorders. Above‐noted results were similar when each BP subtype was analyzed separately. Conclusions: Older age was associated with more severe and typical mood symptomatology. However, there were differences and similarities in type, intensity, and frequency of BP symptoms and comorbid disorders related to age of onset and duration of BP and level of psychosocial development. These factors and the normal difficulties youth have expressing and modulating their emotions may explain existing complexities in diagnosing and treating BP in youth, particular in young children, and suggest the need for developmentally sensitive treatments.Keywords
This publication has 41 references indexed in Scilit:
- Childhood-Onset Bipolar DisorderJournal of the American Academy of Child & Adolescent Psychiatry, 2007
- Psychotic symptoms in pediatric bipolar disorder and family history of psychiatric illnessJournal of Affective Disorders, 2006
- Puberty and DepressionChild and Adolescent Psychiatric Clinics of North America, 2006
- Phenomenology and diagnosis of bipolar disorder in children, adolescents, and adults: Complexities and developmental issuesDevelopment and Psychopathology, 2006
- Clinical correlates of bipolar disorder in a large, referred sample of children and adolescentsJournal of Psychiatric Research, 2005
- Examining the association between pediatric bipolar disorder and anxiety disorders in psychiatrically referred children and adolescentsJournal of Affective Disorders, 2005
- Psychosis and the genetic spectrum of bipolar disorder: evidence from linkage analysisMolecular Psychiatry, 2005
- The clinical characteristics of unipolar vs. bipolar major depression in ADHD youthJournal of Affective Disorders, 2004
- Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problemsJournal of Affective Disorders, 2004
- Is Bipolar Disorder Specifically Associated With Panic Disorder in Youths?Published by Physicians Postgraduate Press, Inc ,2002