Childhood Onset Bipolar Disorder: A Role for Early Recognition and Treatment

  • Russell E. Scheffer
    Correspondence
    Reprint requests: Russell E. Scheffer, MD, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53226.
    Affiliations
    Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
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      Bipolar disorder is a serious mental illness that affects approximately 3% of the adult population.
      • Kessler R.C.
      • Berglund P.
      • Demler O.
      • Jin R.
      • Merikangas K.R.
      • Walters E.E.
      Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.
      • Kessler R.C.
      • Chiu W.T.
      • Demler O.
      • Merikangas K.R.
      • Walters E.E.
      Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.
      • Kessler R.C.
      • Demler O.
      • Frank R.G.
      • Olfson M.
      • Pincus H.A.
      • Walters E.E.
      • et al.
      Prevalence and treatment of mental disorders, 1990 to 2003.
      Additional epidemiological surveys have indicated incidence rates up to 7%. In contrast to previous thought, two-thirds of adult patients diagnosed with bipolar disorder began having symptoms in childhood or adolescence,
      • Lish J.D.
      • Dime-Meenan S.
      • Whybrow P.C.
      • Price R.A.
      • Hirschfeld R.M.
      The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members.
      • Perlis R.H.
      • Miyahara S.
      • Marangell L.B.
      • Wisniewski S.R.
      • Ostacher M.
      • DelBello M.P.
      • et al.
      Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD).
      and between 25% and 33% of youth who initially present with depression will ultimately become manic.
      • Geller B.
      • Zimerman B.
      • Williams M.
      • Bolhofner K.
      • Craney J.L.
      Bipolar disorder at prospective follow-up of adults who had prepubertal major depressive disorder.
      See related article, p 485
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      References

        • Kessler R.C.
        • Berglund P.
        • Demler O.
        • Jin R.
        • Merikangas K.R.
        • Walters E.E.
        Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.
        Arch Gen Psychiatry. 2005; 62: 593-602
        • Kessler R.C.
        • Chiu W.T.
        • Demler O.
        • Merikangas K.R.
        • Walters E.E.
        Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.
        Arch Gen Psychiatry. 2005; 62: 617-627
        • Kessler R.C.
        • Demler O.
        • Frank R.G.
        • Olfson M.
        • Pincus H.A.
        • Walters E.E.
        • et al.
        Prevalence and treatment of mental disorders, 1990 to 2003.
        N Engl J Med. 2005; 352: 2515-2523
        • Lish J.D.
        • Dime-Meenan S.
        • Whybrow P.C.
        • Price R.A.
        • Hirschfeld R.M.
        The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members.
        J Affect Disord. 1994; 31: 281-294
        • Perlis R.H.
        • Miyahara S.
        • Marangell L.B.
        • Wisniewski S.R.
        • Ostacher M.
        • DelBello M.P.
        • et al.
        Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD).
        Biol Psychiatry. 2004; 55: 875-881
        • Geller B.
        • Zimerman B.
        • Williams M.
        • Bolhofner K.
        • Craney J.L.
        Bipolar disorder at prospective follow-up of adults who had prepubertal major depressive disorder.
        Am J Psychiatry. 2001; 158: 125-127
        • Calabrese J.R.
        • Hirschfeld R.M.
        • Frye M.A.
        • Reed M.L.
        Impact of depressive symptoms compared with manic symptoms in bipolar disorder: results of a U.S. community-based sample.
        J Clin Psychiatry. 2004; 65: 1499-1504
        • Leverich G.S.
        • Post R.M.
        • Keck P.E.
        • Altshuler L.L.
        • Frye M.A.
        • Kupka R.W.
        • et al.
        The poor prognosis of childhood onset bipolar disorder: the need for earlier recognition and treatment.
        J Pediatr. 2007; 150: 485-490
        • Geller B.
        • Craney J.L.
        • Bolhofner K.
        • Nickelsburg M.J.
        • Williams M.
        • Zimerman B.
        Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar disorder phenotype.
        Am J Psychiatry. 2002; 159: 927-933
        • Geller B.
        • Tillman R.
        • Craney J.L.
        • Bolhofner K.
        Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype.
        Arch Gen Psychiatry. 2004; 61: 459-467
      1. Post RM, Luckenbaugh DA, Leverich GS. Increased rate of childhood onset bipolar illness in the US compared with two European countries. Brit J Psychiatry. In Press.

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