More pernicious course of bipolar disorder in the United States than in many European countries: Implications for policy and treatment

Post, Robert M.; Altshuler, Lori L.; Kupka, Ralph; McElroy, Susan L.; Frye, Mark A.; Rowe, Michael; Leverich, Gabriele S.; Grunze, Heinz; Suppes, Trisha; Keck, Paul E.; Nolen, Willem A.

doi:10.1016/j.jad.2014.02.006

Cited by 53 publications

(60 citation statements)

References 56 publications

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“…Some types of childhood psychiatric illness may be more prevalent in the US than in many other countries. Data from our international network indicate that patients with bipolar illness from the US have an earlier age of onset of bipolar disorder and a more pernicious course of illness than those from the Netherlands and Germany [4]. The findings of more childhood onset of bipolar disorder in the US compared to Europe have been replicated by Bellivier et al [5] and Etain et al [6].…”

Section: Magnitude Of the Problemmentioning

confidence: 58%

“…Two of the major risk factors for early onset bipolar disordergenetic vulnerability and psychosocial adversity in childhood -are also more prevalent in the US than in Europe [4]. The greater genetic vulnerability in the US appears to have been present for several generations.…”

Section: Potential Reasons For the High Incidence In The Usmentioning

confidence: 99%

“…With the evidence now available that illness trajectory can be dramatically improved with expert treatment [31,35] providing this type of comprehensive treatment on a routine basis for children with major psychiatric illness is highly desirable. Children in the US are at even greater risk for serious psychiatric illness than in many European countries, and special attention to youth in the US is indicated [4].…”

Section: Evidence Of Effectiveness Of Early Interventionmentioning

confidence: 99%

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Children in the US are at High Risk for Psychiatric Disorders: Early Monitoring by Parents May Enhance Awareness and Treatment

Post¹

2016

Pediatr Neurol Med

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Section: Magnitude Of the Problemmentioning

confidence: 58%

Section: Potential Reasons For the High Incidence In The Usmentioning

confidence: 99%

Section: Evidence Of Effectiveness Of Early Interventionmentioning

confidence: 99%

See 1 more Smart Citation

Children in the US are at High Risk for Psychiatric Disorders: Early Monitoring by Parents May Enhance Awareness and Treatment

Post¹

2016

Pediatr Neurol Med

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“…" An early age at onset of both unipolar depression and bipolar disorder has been consistently associated with a more difficult and adverse course of illness into adulthood. [11][12][13][14][15][16][17][18] Thus, early onset may be both a marker of a more severe illness and a portent of many other difficulties, including anxiety and substance abuse comorbidity, more affective episodes, more rapid cycling, and more treatment resistance. 11,[15][16][17][18] In our comparison of bipolar patients from the United States and those from the Netherlands It is illegal to post this copyrighted PDF on any website.…”

mentioning

confidence: 99%

Further Evidence of a Cohort Effect in Bipolar Disorder

Post

Kupka

Keck

et al. 2016

J. Clin. Psychiatry

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Objective: Given that a cohort effect is rarely mentioned as one of the possible contributors to the increased incidence of childhood-onset bipolar disorder in the United States, we reexamined evidence for the phenomenon within our outpatient Bipolar Collaborative Network. Methods: 968 outpatients (mean age, 41 years) with DSM bipolar disorder from 1995 to 2002 from 4 sites in the United States and 3 in the Netherlands and Germany (abbreviated as Europe) gave informed consent and provided detailed demographic, illness, and family history information on a patient questionnaire. Family history of bipolar disorder, depression, suicide attempt, alcohol abuse, substance abuse, and "other" illness was collected for each parent and the 4 grandparents. Age at onset and family history of illness burden were then assessed as a function of the age of the patient at network entry. Results: Data for patients aged 35 years or older (n = 613) were included in the first analysis. Compared to older patients, those who were younger when they entered the network had an earlier age at onset of their bipolar disorder (r = 0.33, P < .001). Similarly, the youngest patients at entry (representing the most recent cohorts) had parents and grandparents with more psychiatric illness than patients born in earlier cohorts (n = 968). Conclusions: These preliminary data, taken with the substantial literature, suggest a cohort effect for earlier age at onset of bipolar disorder and greater burden of psychiatric disorders in 2 generations of direct progenitors of our patients. The resulting likely increase in severity of bipolar illness in future generations based on this earlier age at onset and increased familial loading, particularly in the United States, deserves focused clinical and public health attention and attempts at amelioration.

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“…10 Chang 11 discusses the neurobiological markers of high risk and it is hoped that these in conjunction already known clinical risk variables will help in early recognition and treatment of children in the very earliest prodromes and stages of illness. 12 Even before neurobiological markers become well defined and validated, the currently known clinical risk factors can be utilized in considering early intervention.…”

mentioning

confidence: 99%

This issue: Differentiating Pediatric Bipolar Disorder from Attention-Deficit/Hyperactivity Disorder

Post¹

2014

Psychiatric Annals

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More pernicious course of bipolar disorder in the United States than in many European countries: Implications for policy and treatment

Cited by 53 publications

References 56 publications

Children in the US are at High Risk for Psychiatric Disorders: Early Monitoring by Parents May Enhance Awareness and Treatment

Children in the US are at High Risk for Psychiatric Disorders: Early Monitoring by Parents May Enhance Awareness and Treatment

Further Evidence of a Cohort Effect in Bipolar Disorder

This issue: Differentiating Pediatric Bipolar Disorder from Attention-Deficit/Hyperactivity Disorder

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