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. 2019 Sep;21(6):483-502.
doi: 10.1111/bdi.12785. Epub 2019 May 15.

Childhood factors associated with increased risk for mood episode recurrences in bipolar disorder-A systematic review

Xavier Estrada-Prat  1 , Anna R Van Meter  2 , Ester Camprodon-Rosanas  1   3 , Santiago Batlle-Vila  4 , Benjamin I Goldstein  5   6 , Boris Birmaher  7
Affiliations

Childhood factors associated with increased risk for mood episode recurrences in bipolar disorder-A systematic review

Xavier Estrada-Prat et al. Bipolar Disord. 2019 Sep.

Abstract

Background: Bipolar Disorder (BD) is a recurrent illness associated with high morbidity and mortality. The frequency of mood episode recurrence in BD is highly heterogeneous and significantly impacts the person's psychosocial functioning and well-being. Understanding the factors associated with mood recurrences could inform the prognosis and treatment. The objective of this review is to summarize the literature on factors, present during childhood, that influence recurrence.

Methodology: A systematic review of PubMed (1946-2017) and PsycINFO (1884-2017) databases was conducted to identify candidate studies. Search terms included bipolar disorder, episodes, predictors, recurrences, and course. Study characteristics, risk for bias, and factors associated with recurrence were coded by two raters according to predetermined criteria.

Results: Twenty child studies and 28 adult studies that retrospectively evaluated childhood variables associated with mood recurrences were included. Early age of onset, low socioeconomic status, comorbid disorders, inter-episode subsyndromal mood symptoms, BD-I/II subtypes, presence of stressors, and family history of BD were associated with higher number of recurrences.

Limitations: Risk factors and mood recurrences were assessed and defined in different ways, limiting generalizability.

Conclusion: Multiple factors are associated with increased risk of mood episode recurrence in BD. Interventions targeting modifiable factors could reduce the impact of BD. For example, treatment of comorbid disorders and subsyndromal mood symptoms, coupled with appropriate cognitive behavioral and family-focused therapies could ameliorate risk related to many clinical factors. When coupled with social services to address environmental factors, the number of episodes could be reduced and the course of BD significantly improved.

Keywords: bipolar disorder; recurrence; review; risk factors.

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Conflict of interest statement

Conflict of interest statement:

The authors Anna R. Van Meter, Ester Camprodon-Rosanas, Santiago Batlle-Vila, and Benjamin I. Goldstein have nothing to disclose. All the authors declare no financial interests or potential conflicts of interest related directly or indirectly to this work.

Figures

Figure 1
Figure 1
Study selection
See this image and copyright information in PMC

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