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Treatment Patterns of Youth with Bipolar Disorder: Results from the National Comorbidity Survey—Adolescent Supplement (NCS-A)

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Abstract

Despite growing evidence that bipolar disorder often emerges in adolescence, there are limited data regarding treatment patterns of youth with bipolar disorder in community samples. Our objective was to present the prevalence and clinical correlates of treatment utilization for a nationally representative sample of US adolescents with bipolar disorder. Analyses are based on data from the National Comorbidity Survey-Adolescent Supplement, a face-to-face survey of 10,123 adolescents (ages 13–18) identified in household and school settings. We found that of adolescents meeting DSM-IV criteria for bipolar I or II disorder (N = 250), 49 % were treated for depression or mania, 13 % were treated for conditions other than depression or mania, and 38 % did not report receiving treatment. Treatment for depression or mania was associated with increased rates of suicide attempts, as well as greater role disability and more comorbid alcohol use relative to those who had not received treatment. Treated adolescents had triple the rate of ADHD and double the rates of behavior disorders than those without treatment. Our findings demonstrate that a substantial proportion of youth with bipolar disorder do not receive treatment, and of those who do, many receive treatment for comorbid conditions rather than for their mood-related symptoms. Treatment was more common among youth with severe manifestations and consequences of bipolar disorder and those with behavior problems. These trends highlight the need to identify barriers to treatment for adolescents with bipolar disorder and demonstrate that those in treatment are not representative of youth with bipolar disorder in the general population.

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Acknowledgments

This work was supported by the Intramural Research Program of the National Institute of Mental Health (Z01 MH002808-08). The National Comorbidity Survey Adolescent Supplement (NCS-A) and the larger program of related NCS surveys are supported by the National Institute of Mental Health (U01-MH60220). The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government.

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The authors do not have any commercial associations that might present a conflict of interest with this manuscript.

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Authors and Affiliations

  1. Genetic Epidemiology Research Branch, National Institute of Mental Health, Bldg. 35A, Rm 2E410, 35 Convent Dr. MSC 3720, Bethesda, MD, 20892-0001, USA

    Gabriela Kattan Khazanov, Lihong Cui & Kathleen Ries Merikangas

  2. Zurich University Psychiatric Hospital, Zurich, Switzerland

    Jules Angst

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  1. Gabriela Kattan Khazanov
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  2. Lihong Cui
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  3. Kathleen Ries Merikangas
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  4. Jules Angst
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Correspondence to Kathleen Ries Merikangas.

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Khazanov, G.K., Cui, L., Merikangas, K.R. et al. Treatment Patterns of Youth with Bipolar Disorder: Results from the National Comorbidity Survey—Adolescent Supplement (NCS-A). J Abnorm Child Psychol 43, 391–400 (2015). https://doi.org/10.1007/s10802-014-9885-6

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