A prospective 4–5 year follow‐up of juvenile onset bipolar disorder

Jairam, Rajeev; Srinath, Shoba; Girimaji, Satish Chandra; Seshadri, Shekhar

doi:10.1111/j.1399-5618.2004.00149.x

Cited by 70 publications

(72 citation statements)

References 40 publications

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“…The mean duration of stay in our sample (10 weeks) is much higher than other studies. Twenty-eight days was the mean duration of hospital stay in an Indian prospective study [29]. These results are consistent with the clinical severity of our BD-I sample.…”

Section: Discussion J Limitations and Strengthssupporting

confidence: 79%

“…To our knowledge, there is no other study on acute mania phenomenology in adolescents with MR. The rate of psychotic features in this sample is among the highest rates found in previous studies (50-60%) [9,47,29]. The mean duration of stay in our sample (10 weeks) is much higher than other studies.…”

Section: Discussion J Limitations and Strengthscontrasting

confidence: 36%

“…Furthermore, some studies include children and adolescent with bipolar spectrum disorders, who can be inpatient or outpatient subjects, whereas others evaluate hospitalized adolescent bipolar type I disorder, like in our study. To compare our results, we found few prospective studies, including clinical samples and a single community study, that focused on and recruited actively ill BD-I subjects with classic manic elation and/or grandiosity, like our sample [5,18,26,29,39,50,52]. Strober et al [52] in a study on the longitudinal course of 54 adolescent inpatients with BD-I, showed that the length of time to obtain remission was shorter for manic subjects compared with mixed ones.…”

Section: Discussion J Limitations and Strengthsmentioning

confidence: 99%

“…Possibly, there is a better response to mood stabilizators in pure manic episodes compared to mixed episodes in adolescents. In a study [29] that included 25 youths with BD-I, the presence of a previous affective episode was the only predictive factor of recovery, and was associated with a longer duration of index episode. Birmaher et al [5], in a 2-year follow-up study of 263 children and adolescents with bipolar spectrum disorders, identified several variables associated with prognosis.…”

Section: Discussion J Limitations and Strengthsmentioning

confidence: 99%

“…To summarize, mixed polarity, low socioeconomic status (SES), young age at onset, previous affective episode, psychosis and female sex were associated at least in one study with a poorer outcome [5,18,27,29,52]. Furthermore, in the US, inpatient treatment tends to be shorter and shorter (median lenght of stay for BD in 2000 is 5.6 days) due to economic pressures [12], which leads to a bias in short-term prognosis studies.…”

Section: Introductionmentioning

confidence: 99%

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Phenomenology, socio-demographic factors and outcome upon discharge of manic and mixed episodes in hospitalized adolescents

Brunelle

Consoli

Tanguy

et al. 2009

Eur Child Adolesc Psychiatry

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Med J 29, 2006). Little is known on the phenomenology and potential short-term prognosis factors of bipolar episodes in this age population. In particular, very few studies examine this issue on inpatients in the European context of free access to care. Objective To describe the phenomenology of acute manic and mixed episodes in hospitalized adolescents and to analyse potential predictive factors associated with clinical improvement at discharge and length of hospitalization. Methods A total of 80 subjects, aged 12-20 years, consecutively hospitalized for a manic or mixed episode. Sociodemographic and clinical data were extracted by reviewing patients' charts. We used a multivariate analysis to evaluate shortterm outcome predictors. Results The sample was characterized by severe impairment, high rates of psychotic features (N = 50, 62.5%), a long duration of stay (mean 80.4 days), and an overall good improvement (86% very much or much improved). Thirtythree (41.3 %) patients had a history of depressive episodes, 13 (16.3%) had manic or brief psychotic episodes but only 3 (3.7%) had a history of attention deficit/ hyperactivity disorders. More manic episodes than mixed episodes were identified in subjects with mental retardation (MR) and in subjects from migrant and/or low socio-economic families. Overall severity and female gender predicted better improvement in GAF scores. Poor insight and the existence of psychotic features predicted longer duration of stay. Conclusion These results suggest that severe manic and mixed episodes in adolescents with BD-I need prolonged inpatient care to improve and that socio-cultural factors and MR should be examined more closely in youth with BD.j Key words bipolar disorder type I -acute episodeadolescent -prognosissocio-cultural factors BRIEF REPORT

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Section: Discussion J Limitations and Strengthssupporting

confidence: 79%

Section: Discussion J Limitations and Strengthscontrasting

confidence: 36%

Section: Discussion J Limitations and Strengthsmentioning

confidence: 99%

Section: Discussion J Limitations and Strengthsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Phenomenology, socio-demographic factors and outcome upon discharge of manic and mixed episodes in hospitalized adolescents

Brunelle

Consoli

Tanguy

et al. 2009

Eur Child Adolesc Psychiatry

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Clinical Course of Children and Adolescents With Bipolar Spectrum Disorders

Birmaher

Axelson²,

Strober³

et al. 2006

Arch Gen Psychiatry

585

539

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National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth

Moreno

Laje²,

Blanco³

et al. 2007

Arch Gen Psychiatry

609

331

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Although bipolar disorder may have its onset during childhood, little is known about national trends in the diagnosis and management of bipolar disorder in young people.Objectives: To present national trends in outpatient visits with a diagnosis of bipolar disorder and to compare the treatment provided to youth and adults during those visits.Design: We compare rates of growth between 1994-1995 and 2002-2003 in visits with a bipolar disorder diagnosis by individuals aged 0 to 19 years vs those aged 20 years or older. For the period of 1999 to 2003, we also compare demographic, clinical, and treatment characteristics of youth and adult bipolar disorder visits.Setting: Outpatient visits to physicians in office-based practice.Participants: Patient visits from the National Ambulatory Medical Care Survey (1999)(2000)(2001)(2002)(2003) with a bipolar disorder diagnosis (n = 962).Main Outcome Measures: Visits with a diagnosis of bipolar disorder by youth (aged 0-19 years) and by adults (aged Ն20 years). Results:The estimated annual number of youth office-based visits with a diagnosis of bipolar disorder increased from 25 (1994)(1995) to 1003 (2002-2003) visits per 100 000 population, and adult visits with a diagnosis of bipolar disorder increased from 905 to 1679 visits per 100 000 population during this period. In 1999 to 2003, most youth bipolar disorder visits were by males (66.5%), whereas most adult bipolar disorder visits were by females (67.6%); youth were more likely than adults to receive a comorbid diagnosis of attention-deficit/hyperactivity disorder (32.2% vs 3.0%, respectively; P Ͻ .001); and most youth (90.6%) and adults (86.4%) received a psychotropic medication during bipolar disorder visits, with comparable rates of mood stabilizers, antipsychotics, and antidepressants prescribed for both age groups.Conclusions: There has been a recent rapid increase in the diagnosis of youth bipolar disorder in office-based medical settings. This increase highlights a need for clinical epidemiological reliability studies to determine the accuracy of clinical diagnoses of child and adolescent bipolar disorder in community practice.

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A prospective 4–5 year follow‐up of juvenile onset bipolar disorder

Cited by 70 publications

References 40 publications

Phenomenology, socio-demographic factors and outcome upon discharge of manic and mixed episodes in hospitalized adolescents

Phenomenology, socio-demographic factors and outcome upon discharge of manic and mixed episodes in hospitalized adolescents

Clinical Course of Children and Adolescents With Bipolar Spectrum Disorders

National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth

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