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. 2023 Apr;17(4):385-393.
doi: 10.1111/eip.13335. Epub 2022 Jun 14.

Prevalence and correlates of childhood-onset bipolar disorder among adolescents

Jessica Barton  1 , Megan Mio  1   2 , Vanessa Timmins  1 , Rachel H B Mitchell  3 , Benjamin I Goldstein  1   2   3
Affiliations

Prevalence and correlates of childhood-onset bipolar disorder among adolescents

Jessica Barton et al. Early Interv Psychiatry. 2023 Apr.

Abstract

Aim: Early-onset bipolar disorder (BD) is associated with a more severe illness as well as a number of clinical factors among adults. Early-onset can be categorized as childhood- (age < 13) or adolescent- (age ≥ 13) onset, with the two displaying different clinical profiles. We set out to examine differences in clinical, and familial characteristics among adolescents with childhood- versus adolescent-onset BD.

Methods: The study included 195 adolescents with BD, ages 14-18 years. Age of onset was determined retrospectively by self-report. Participants completed the semi-structured K-SADS-PL diagnostic interviews along with self-reported dimensional scales. Analyses examined between-group differences for clinical and familial variables. Variables associated with age of onset at p < 0.1 in univariate analyses were evaluated in a logistic regression model.

Results: Approximately one-fifth of participants had childhood-onset BD (n = 35; 17.9%). A number of clinical and familial factors were significantly associated with childhood-onset BD. However, there were no significant differences in depressive and manic symptom severity. In multivariate analyses, the variables most strongly associated with childhood-onset were police contact, and family history of suicidal ideation. Smoking and psychiatric hospitalization were associated with adolescent-onset.

Conclusions: In this large clinical sample of adolescents with BD, one-fifth reported childhood-onset BD. Correlates of childhood-onset generally aligned with those observed in the literature. Future research is warranted to better understand the genetic and environmental implications of high familial loading of psychopathology associated with childhood-onset, and to integrate age-related treatment and prevention strategies.

Keywords: adolescent-onset; age-related treatment; bipolar disorder; childhood-onset; familial loading.

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References

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