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...
Autores principales: | , , , , , , , |
---|---|
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 |