BIPOLAR IS CHILDREN

A Research Paper On Bipolar In Children

Outline For The Paper

Objective: The aim of the study was to examine antecedent childhood psychiatric disorders in adult patients with bipolar disorder.

Method: Using structured diagnostic interviews, childhood psychiatric diagnoses of 83 referred patients with diagnosed DSM-IV bipolar disorder were compared to those of 308 adults without mood disorders.

Results: Patients with bipolar disorder had significantly higher rates of childhood disruptive behavior disorders (ADHD, oppositional-defiant disorder, and conduct disorder), childhood anxiety disorders (separation anxiety and overanxious disorder), and enuresis, compared to patients without mood disorders. The presence of these childhood disorders was associated with an earlier age of onset of bipolar illness.

Limitations: The retrospective nature of the study may have affected both the rates of disorders recalled, as well as the ages of onset of disorders. Different referral sources for bipolar and comparison participants may have also impacted findings.

Conclusions: Bipolar disorder in adults is frequently preceded by childhood disruptive behavior and anxiety disorders. These childhood disorders may be important markers of risk for adult bipolar disorder.

Keywords: Bipolar disorder; Childhood disorders;Adult; Mood disorders; ADHD

Bipolar Is Children

While it is increasingly recognized that adult psychiatric disorders are often preceded by childhood disorders, little is known about the scope or impact of antecedent childhood disorders in adults with bipolar disorder. The extant literature on the subject consists of only five studies (Carlson et al., 2002, Egeland et al., 2000, Manzano and Salvador, 1993, Sachs et al., 1994 and Winokur et al., 1993). Of these, three studies have only examined the prevalence of disruptive behavior disorders (Carlson et al., 2002, Sachs et al., 1994 and Winokur et al., 1993), and all but one study (Winokur et al., 1993) have lacked appropriate comparison groups.

There is indirect evidence that, in addition to disruptive behavior disorders, childhood anxiety disorders may be important antecedents to adult bipolar disorder. An emerging literature documents that pediatric bipolar disorder is frequently comorbid not only with disruptive behavior disorders but also with anxiety disorders (Biederman et al., 1999, Geller et al., 2002, Masi et al., 2001 and Wozniak et al., 1995). Likewise, high-risk studies of the offspring of adults with bipolar disorder document that these children are frequently afflicted early on in life with both disruptive and anxiety disorders (Carlson and Weintraub, 1993, Hammen et al., 1990, Henin et al., 2005 and Shaw et al., 2005). Thus, there remains a need for well-controlled, well-powered studies of adults with bipolar disorder aimed at understanding the scope and magnitude of childhood precursors of this disorder.

A better understanding of the childhood precursors of bipolar disorder has important clinical and scientific implications. Since many of these childhood disorders may persist into adult life they can complicate the course and management of adults with bipolar disorder. Moreover, the identification of childhood disorders among bipolar adults would provide a means of clarifying the early course of bipolar disorder. This knowledge would enable the identification of a subgroup of children at very high-risk for bipolar disorder, and facilitate the development of specific preventive and early ...