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Singh MK, Post RM, Miklowitz DJ, et al. A commentary on youth onset bipolar disorder. Bipolar Disord. 2021;doi: 10.1111/bdi.13148.
Singh, M. K., Post, R. M., Miklowitz, D. J., Birmaher, B., Youngstrom, E., Goldstein, B., Soutullo, C., Axelson, D., Chang, K. D., & DelBello, M. P. (2021). A commentary on youth onset bipolar disorder. Bipolar disorders, . https://doi.org/10.1111/bdi.13148
Singh, Manpreet K, et al. "A commentary on youth onset bipolar disorder." Bipolar disorders vol. (2021). doi: https://doi.org/10.1111/bdi.13148
Singh MK, Post RM, Miklowitz DJ, Birmaher B, Youngstrom E, Goldstein B, Soutullo C, Axelson D, Chang KD, DelBello MP. A commentary on youth onset bipolar disorder. Bipolar Disord. 2021 Oct 24; doi: 10.1111/bdi.13148. Epub 2021 Oct 24. PMID: 34689401.
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Bipolar Disord. 2021 Oct 24; doi: 10.1111/bdi.13148. Epub 2021 Oct 24.

A commentary on youth onset bipolar disorder.

Bipolar disorders

Manpreet K Singh, Robert M Post, David J Miklowitz, Boris Birmaher, Eric Youngstrom, Benjamin Goldstein, Cesar Soutullo, David Axelson, Kiki D Chang, Melissa P DelBello

Affiliations

  1. Stanford University School of Medicine, Stanford, California, USA.
  2. Bipolar Collaborative Network, Bethesda, Maryland, USA.
  3. University of California in Los Angeles School of Medicine, Los Angeles, California, USA.
  4. University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  5. University of North Carolina, Chapel Hill, North Carolina, USA.
  6. Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  7. The University of Texas Health Science Center, Houston, Texas, USA.
  8. Nationwide Children's Hospital, Columbus, Ohio, USA.
  9. Private Practice, Palo Alto, California, USA.
  10. University of Cincinnati, Cincinnati, Ohio, USA.

PMID: 34689401 DOI: 10.1111/bdi.13148

Abstract

AIM: Given ongoing disagreement about the diagnosis of pediatric bipolar disorder, we sought to illuminate key empirical findings regarding the condition in children and adolescents.

METHODS: We conducted a review of extant studies of the diagnosis, course, and treatment of bipolar disorder in children and adolescents.

RESULTS: Bipolar disorder is a lifelong, familial condition with frequent onset in childhood or adolescence. Secular trends indicate that globally, the onset of puberty is occurring earlier, which may contribute to increased identification of mood disorders in younger populations. Despite opinions to the contrary, bipolar disorder has been observed in youth around the world, not just in the U.S. Discrete and episodic manic symptoms occur on a continuum/spectrum of severity and duration. Clinicians may be just as likely to miss mania (false negatives) as overcall it (false positives). As is true in adults, periodicity and heterogeneity are defining features of early onset bipolar disorder. Youth who are misdiagnosed and undiagnosed tend to do poorly over the long term. Youth with and at risk for bipolar disorder are frequently exposed to maltreatment, abuse, and bullying. Fortunately, there are now many evidence-based interventions that have been studied in thousands of youth with or at high risk for bipolar disorder, demonstrating large effect sizes for evaluated treatments versus comparative treatments.

CONCLUSION: Identifying optimal methods for the evaluation and treatment of bipolar disorder in children and adolescents represents important advances in the field. Recognizing the occurrence of mania symptoms in youth is pivotal for improving outcomes in patients living with bipolar disorder.

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Keywords: diagnosis; early onset; pediatric bipolar disorder; treatment

References

  1. Hafeman DM, Goldstein TR, Strober M, et al. Prospectively ascertained mania and hypomania among young adults with child- and adolescent-onset bipolar disorder. Bipolar Disord. 2021;23(5):463-473. doi:10.1111/bdi.13034 - PubMed
  2. Post RM, Kupka R, Keck PE, et al. Further evidence of a cohort effect in bipolar disorder: more early onsets and family history of psychiatric illness in more recent epochs. J Clin Psychiatry. 2016;77(8):1043-1049. doi: 10.4088/JCP.15m10121 - PubMed
  3. Youngstrom EA, Genzlinger JE, Egerton GA, Van Meter AR. Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: mother knows best about mania. Arch Sci Psychol. 2015;3(1):112-137. doi: 10.1037/arc0000024 - PubMed
  4. Van Meter A, Moreira ALR, Youngstrom E. Updated meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry. 2019;80(3): doi: 10.4088/JCP.18r12180 - PubMed
  5. Miklowitz DJ, Efthimiou O, Furukawa TA, et al. Adjunctive psychotherapy for bipolar disorder: a systematic review and component network meta-analysis. JAMA Psychiatry. 2021;78(2):141. doi: 10.1001/jamapsychiatry.2020.2993 - PubMed

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