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Outcomes for Youths with Early- and Very-Early-Onset Bipolar I Disorder

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Abstract

To examine differences between children and adolescents with bipolar I disorder in a public mental health system, medical records and computerized data files were reviewed for 82 newly admitted patients, focusing on documented diagnoses, clinical features, services and medications received, and psychosocial functioning changes over 18 months. Suicidality, violent or aggressive behavior, psychotic features, and severe/frequent mood changes were prevalent in 40–70% of the cohort, with children more likely to have comorbid attention deficit hyperactivity disorder and adolescents more likely to have substance-related problems. For clients who remained in treatment, functioning ratings improved over 18 months on multiple dimensions but were unrelated to type of service or pharmacotherapy received.

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References

  1. Biederman J, Faraone SV, Wozniak J, Mick E, Kwon A, Aleardi M. Further evidence of unique developmental phenotypic correlates of pediatric bipolar disorder: findings from a large sample of clinically referred preadolescent children assessed over the last 7 years. Journal of Affective Disorders. 2004;82S:S45–S58.

    Article  Google Scholar 

  2. Geller B, Tillman R, Craney JL, Bulhofner K. Four-year prospective outcome and natural history of mania in children with prepubertal and early adolescent bipolar phenotype. Archives of General Psychiatry. 2004;61:459–467.

    Article  PubMed  Google Scholar 

  3. Ernst CL, Goldberg JF. Clinical features related to age at onset in bipolar disorder. Journal of Affective Disorders. 2004;82:21–27.

    Article  PubMed  Google Scholar 

  4. Jerrell JM, Shugart MA. Community-based care for youths with early and very-early onset bipolar I disorder. Bipolar Disorders. 2004;6:299–304.

    Article  PubMed  Google Scholar 

  5. Wozniak J. Recognizing and managing bipolar disorder in children. Journal of Clinical Psychiatry. 2005;66(Suppl 1):18–23.

    PubMed  Google Scholar 

  6. Geller B, Zimerman B, Bolhofner K, Craney JL, DelBello MP, Soutullo CA. Diagnostic characteristics of 93 cases of a prepubertal and early adolescent bipolar disorder phenotype by gender, puberty and comorbid ADHD. Journal of Child and Adolescent Psychopharmacology. 2000;10:157–164.

    Article  PubMed  CAS  Google Scholar 

  7. Geller B, Craney JL, Bolhofner K, DelBello MP, Axelson D, Luby J, Williams M, Zimerman B, Nickelsburg MJ, Frazier J, Beringer L. Phenomenology and longitudinal course of children with prepubertal and early adolescent bipolar disorder phenotype. In: Geller B, DelBello M, eds. Bipolar Disorder in Childhood and Early Adolescence. New York: The Guilford Press; 2003:25–50.

    Google Scholar 

  8. Dunner DL. Atypical antipsychotics: efficacy across bipolar disorder subpopulations. Journal of Clinical Psychiatry. 2005;66(Suppl. 3):20–27.

    PubMed  CAS  Google Scholar 

  9. Pavluri MN, Henry DB, Carbray JA, Sampson G, Naylor MW, Janicak PG. Open-label prospective trial of risperidone in combination with lithium or divalproex sodium in pediatric mania. Journal of Affective Disorders. 2004;82S:S103–S111.

    Article  Google Scholar 

  10. Wozniak J, Spencer T, Biederman J, Kwon A, Monuteaux M, Rettew J, Lail K. The clinical characteristics of unipolar vs. bipolar major depression in ADHD youth. Journal of Affective Disorders. 2004;82S:S59–S69.

    Article  Google Scholar 

  11. Kowatch RA, Suppes T, Carmody TJ, Bucci JP, Hume JH, Kromelis M, Emslie GJ, Weinberg WA, Rush JA. Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2000;39(6):713–720.

    Article  PubMed  CAS  Google Scholar 

  12. Scheffer RE, Kowatch RA, Carmody T, Rush AJ. Randomized, placebo-controlled trial of mixed amphetamine salts for symptoms of comorbid ADHD in pediatric bipolar disorder after mood stabilization with divalproex sodium. American Journal of Psychiatry. 2005;162:58–64.

    Article  PubMed  Google Scholar 

  13. Strober M, Schmidt-Lackner S, Freeman R, Bower S, Lampert C, DeAntonio M. Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up. Journal of the American Academy of Child and Adolescent Psychiatry. 1995;34(6):724–731.

    Article  PubMed  CAS  Google Scholar 

  14. Weller EB, Danielyan AK, Weller RA. Somatic treatment of bipolar disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America 2002;11:595–617.

    Article  PubMed  Google Scholar 

  15. Hodges K. Child and Adolescent Functional Assessment Scale. Ann Arbor: Functional Assessment Systems, LLC; 2003.

    Google Scholar 

Download references

Acknowledgement

This research was performed in the South Carolina Department of Mental Health (SC DMH) and was supported by a contract from the SC DMH for data collection and a small grant from the Central Carolina Foundation for data analysis. The views expressed do not necessarily represent those of the funding agencies. The authors gratefully acknowledge the assistance of Kristin Wieduwilt in performing the data analyses. The authors are Professor of Neuropsychiatry and Behavioral Science, and Child and Adolescent Psychiatry Fellow, School of Medicine, University of South Carolina, respectively.

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Correspondence to Jeanette M. Jerrell PhD.

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Jerrell, J.M., Prewette, E.D. Outcomes for Youths with Early- and Very-Early-Onset Bipolar I Disorder. J Behav Health Serv Res 35, 52–59 (2008). https://doi.org/10.1007/s11414-007-9081-3

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  • DOI: https://doi.org/10.1007/s11414-007-9081-3

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