Persistence of childhood bipolar I disorder into adulthood
Findings from a study recently reviewed by Journal Watch (jwatch.org), a physician edited source focused on research and news, reported a significant rate of persistence of childhood bipolar I disorder into adulthood. The study, which examined 115 children with a mean age of 11 years, ultimately concluded that bipolar I disorder persisted into adulthood in 44% of participants. One weakness of the study, however, is that it did not report findings about participants beyond the age of 19. Additionally, the study is not reflective of subsyndromal and bipolar II disorder persistence into adulthood. Nonetheless, the study sheds light on the widely discussed topic of age at the time of mental illness onset. The following is an excerpt of the Journal Watch article:
The researchers used a stringent definition of childhood bipolar I disorder: Diagnosis of mania required elation, grandiosity, or both. Most subjects (94%) completed all assessments during the 8-year follow-up (every 6 months for 2 years, yearly for 4 years, and a final assessment 2 years later). About half of the participants were 18 or older at the final assessment.
Of the group, 88% recovered from the index manic episode (mean time to recovery, 55.6 weeks); 73% of these subjects relapsed to mania, on average 99 weeks later. Although significantly shorter than the index episode, later manic episodes were lengthy (mean duration: second episode, 55 weeks; third episode, 40 weeks) and were marked by psychosis and ultradian cycling. Participants younger than 18 years were ill 66% of the time; the percentage dropped to 49% among patients 18 or older. Low maternal warmth and earlier age at onset predicted longer time ill with manic episodes. At age 18 or older, 44% of participants had manic episodes, and 35% developed a substance-use disorder.