Cargando…

Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample

BACKGROUND: Approximately 30%–60% of adults diagnosed with bipolar disorder (BD) report onset between the ages 15 and 19 years; however, a correct diagnosis is often delayed by several years. Therefore, investigations of the early features of BD are important for adequately understanding the prodrom...

Descripción completa

Detalles Bibliográficos
Autores principales: Goetz, Michal, Novak, Tomas, Vesela, Marie, Hlavka, Zdenek, Brunovsky, Martin, Povazan, Michal, Ptacek, Radek, Sebela, Antonin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639550/
https://www.ncbi.nlm.nih.gov/pubmed/26604770
http://dx.doi.org/10.2147/NDT.S79586
_version_ 1782399935182798848
author Goetz, Michal
Novak, Tomas
Vesela, Marie
Hlavka, Zdenek
Brunovsky, Martin
Povazan, Michal
Ptacek, Radek
Sebela, Antonin
author_facet Goetz, Michal
Novak, Tomas
Vesela, Marie
Hlavka, Zdenek
Brunovsky, Martin
Povazan, Michal
Ptacek, Radek
Sebela, Antonin
author_sort Goetz, Michal
collection PubMed
description BACKGROUND: Approximately 30%–60% of adults diagnosed with bipolar disorder (BD) report onset between the ages 15 and 19 years; however, a correct diagnosis is often delayed by several years. Therefore, investigations of the early features of BD are important for adequately understanding the prodromal stages of the illness. METHODS: A complete review of the medical records of 46 children and adolescents who were hospitalized for BD at two psychiatric teaching centers in Prague, Czech Republic was performed. Frequency of BD in all inpatients, age of symptom onset, phenomenology of mood episodes, lifetime psychiatric comorbidity, differences between very-early-onset (<13 years of age) and early-onset patients (13–18 years), and differences between the offspring of parents with and without BD were analyzed. RESULTS: The sample represents 0.83% of the total number of inpatients (n=5,483) admitted during the study period at both centers. BD often started with depression (56%), followed by hypomania (24%) and mixed episodes (20%). The average age during the first mood episode was 14.9 years (14.6 years for depression and 15.6 years for hypomania). Seven children (15%) experienced their first mood episode before age 13 years (very early onset). Traumatic events, first-degree relatives with mood disorders, and attention deficit hyperactivity disorder were significantly more frequent in the very-early-onset group vs the early-onset group (13–18 years) (P≤0.05). The offspring of bipolar parents were significantly younger at the onset of the first mood episode (13.2 vs 15.4 years; P=0.02) and when experiencing the first mania compared to the offspring of non-BD parents (14.3 vs 15.9 years; P=0.03). Anxiety disorders, substance abuse, specific learning disabilities, and attention deficit hyperactivity disorder were the most frequent lifetime comorbid conditions. CONCLUSION: Clinicians must be aware of the potential for childhood BD onset in patients who suffer from recurrent depression, who have first-degree relatives with BD, and who have experienced severe psychosocial stressors.
format Online
Article
Text
id pubmed-4639550
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-46395502015-11-24 Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample Goetz, Michal Novak, Tomas Vesela, Marie Hlavka, Zdenek Brunovsky, Martin Povazan, Michal Ptacek, Radek Sebela, Antonin Neuropsychiatr Dis Treat Original Research BACKGROUND: Approximately 30%–60% of adults diagnosed with bipolar disorder (BD) report onset between the ages 15 and 19 years; however, a correct diagnosis is often delayed by several years. Therefore, investigations of the early features of BD are important for adequately understanding the prodromal stages of the illness. METHODS: A complete review of the medical records of 46 children and adolescents who were hospitalized for BD at two psychiatric teaching centers in Prague, Czech Republic was performed. Frequency of BD in all inpatients, age of symptom onset, phenomenology of mood episodes, lifetime psychiatric comorbidity, differences between very-early-onset (<13 years of age) and early-onset patients (13–18 years), and differences between the offspring of parents with and without BD were analyzed. RESULTS: The sample represents 0.83% of the total number of inpatients (n=5,483) admitted during the study period at both centers. BD often started with depression (56%), followed by hypomania (24%) and mixed episodes (20%). The average age during the first mood episode was 14.9 years (14.6 years for depression and 15.6 years for hypomania). Seven children (15%) experienced their first mood episode before age 13 years (very early onset). Traumatic events, first-degree relatives with mood disorders, and attention deficit hyperactivity disorder were significantly more frequent in the very-early-onset group vs the early-onset group (13–18 years) (P≤0.05). The offspring of bipolar parents were significantly younger at the onset of the first mood episode (13.2 vs 15.4 years; P=0.02) and when experiencing the first mania compared to the offspring of non-BD parents (14.3 vs 15.9 years; P=0.03). Anxiety disorders, substance abuse, specific learning disabilities, and attention deficit hyperactivity disorder were the most frequent lifetime comorbid conditions. CONCLUSION: Clinicians must be aware of the potential for childhood BD onset in patients who suffer from recurrent depression, who have first-degree relatives with BD, and who have experienced severe psychosocial stressors. Dove Medical Press 2015-11-04 /pmc/articles/PMC4639550/ /pubmed/26604770 http://dx.doi.org/10.2147/NDT.S79586 Text en © 2015 Goetz et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Goetz, Michal
Novak, Tomas
Vesela, Marie
Hlavka, Zdenek
Brunovsky, Martin
Povazan, Michal
Ptacek, Radek
Sebela, Antonin
Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample
title Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample
title_full Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample
title_fullStr Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample
title_full_unstemmed Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample
title_short Early stages of pediatric bipolar disorder: retrospective analysis of a Czech inpatient sample
title_sort early stages of pediatric bipolar disorder: retrospective analysis of a czech inpatient sample
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639550/
https://www.ncbi.nlm.nih.gov/pubmed/26604770
http://dx.doi.org/10.2147/NDT.S79586
work_keys_str_mv AT goetzmichal earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT novaktomas earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT veselamarie earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT hlavkazdenek earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT brunovskymartin earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT povazanmichal earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT ptacekradek earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample
AT sebelaantonin earlystagesofpediatricbipolardisorderretrospectiveanalysisofaczechinpatientsample