Predictors of longitudinal psychosocial functioning in bipolar youth transitioning to adults

Hower, Heather; Lee, Erica J.; Jones, Richard N.; Birmaher, Boris; Goldstein, Benjamin I.; Merranko, John; Keller, Martin B.; Goldstein, Tina R.; Weinstock, Lauren M.; Dickstein, Daniel P.; Hunt, Jeffrey; Diler, Rasim Somer; Gill, Mary Kay; Axelson, David; Yen, Shirley

doi:10.1016/j.jad.2018.12.108

Cited by 19 publications

(11 citation statements)

References 57 publications

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“…Less severe positive symptoms at baseline predicted a Moderate impairment-Stable trajectory vs. a Severe impairment-Stable trajectory. These results are in agreement with previous studies performed in FEP and chronic psychiatric samples, where parental SES [ 17 , 63 ], negative [ 14 , 64 , 65 ] and depressive symptoms [ 66 , 67 ], verbal memory [ 64 ], and premorbid adjustment [ 14 , 68 ] were predictors of functional outcomes. To our knowledge, however, this is the first study to simultaneously analyze such a large panel of potential predictors of mid-term psychosocial functioning trajectories identified using an LCGA approach, which included sociodemographic, clinical, and neurocognitive variables, and to further examine the interaction between the identified predictors.…”

Section: Discussionsupporting

confidence: 93%

Exploring Risk and Resilient Profiles for Functional Impairment and Baseline Predictors in a 2-Year Follow-Up First-Episode Psychosis Cohort Using Latent Class Growth Analysis

Salagre

Grande

Solé

et al. 2020

JCM

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Being able to predict functional outcomes after First-Episode Psychosis (FEP) is a major goal in psychiatry. Thus, we aimed to identify trajectories of psychosocial functioning in a FEP cohort followed-up for 2 years in order to find premorbid/baseline predictors for each trajectory. Additionally, we explored diagnosis distribution within the different trajectories. A total of 261 adults with FEP were included. Latent class growth analysis identified four distinct trajectories: Mild impairment-Improving trajectory (Mi-I) (38.31% of the sample), Moderate impairment-Stable trajectory (Mo-S) (18.39%), Severe impairment-Improving trajectory (Se-I) (12.26%), and Severe impairment-Stable trajectory (Se-S) (31.03%). Participants in the Mi-I trajectory were more likely to have higher parental socioeconomic status, less severe baseline depressive and negative symptoms, and better premorbid adjustment than individuals in the Se-S trajectory. Participants in the Se-I trajectory were more likely to have better baseline verbal learning and memory and better premorbid adjustment than those in the Se-S trajectory. Lower baseline positive symptoms predicted a Mo-S trajectory vs. Se-S trajectory. Diagnoses of Bipolar disorder and Other psychoses were more prevalent among individuals falling into Mi-I trajectory. Our findings suggest four distinct trajectories of psychosocial functioning after FEP. We also identified social, clinical, and cognitive factors associated with more resilient trajectories, thus providing insights for early interventions targeting psychosocial functioning.

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Section: Discussionsupporting

confidence: 93%

Exploring Risk and Resilient Profiles for Functional Impairment and Baseline Predictors in a 2-Year Follow-Up First-Episode Psychosis Cohort Using Latent Class Growth Analysis

Salagre

Grande

Solé

et al. 2020

JCM

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“…Thalamus–superior temporal gyrus hypoconnectivity in BD-risk youth was associated with decreased prosocial behaviors at, on average, 4-year follow-up. Lower prosocial behavior may be indicative of a higher likelihood of clinically significant social and behavioral problems in the future [ 55 , 56 ]. Prosocial behaviors are commonly developed in adolescence, when both social development [ 57 ] and mania onset [ 3 ] are most acutely experienced.…”

Section: Discussionmentioning

confidence: 99%

Neural correlates of reward processing distinguish healthy youth at familial risk for bipolar disorder from youth at familial risk for major depressive disorder

et al. 2022

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Youth at familial risk for bipolar disorder (BD-risk) and major depressive disorder (MDD-risk) have aberrant reward processing, a core feature of these mood disorders. Whether BD risk differentiates from MDD risk in reward processing merits further study. We compared neural activation and connectivity during anticipation and outcome of monetary gain and loss during fMRI using the Monetary Incentive Delay (MID) Task among BD-risk (n = 40), MDD-risk (n = 41), and healthy comparison youth (HC) (n = 45), in the absence of any lifetime or current history of psychopathology [mean age 13.09 ± 2.58, 56.3% female]. Participants completed the MID task at baseline and were followed for behavioral and clinical outcomes over 4.37 ± 2.29 years. Region-of-interest (ROI) analyses conducted using anatomically defined thalamus, ventrolateral prefrontal cortex, nucleus accumbens, and putamen seeds showed that relative to MDD-risk and HC, BD-risk had decreased activation of the thalamus during anticipation of monetary gain [F(2,118) = 4.64, p = 0.01 (FDR-corrected p = 0.04)]. Psychophysiological interaction analyses revealed that BD-risk had less connectivity between the thalamus and left middle frontal gyrus (Z > 3.1, p < 0.001) and left-superior temporal gyrus (Z > 3.1, p < 0.05) compared with MDD-risk. Voxelwise, BD-risk had decreased activation in the cerebellum during anticipation and outcome of monetary gain relative to MDD-risk and HC (Z > 3.1, p < 0.001; Z > 3.1, p < 0.01). In BD-risk, decreased thalamic connectivity was associated with increased impulsivity at baseline and reduced prosocial behavior at follow-up. Reduced thalamic activation and connectivity during reward processing may distinguish familial risk for BD from familial risk for MDD and represent early markers of vulnerability that may herald social dysfunction later in adolescence.

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“…More stable mood was associated with better psychosocial functioning, but some impairment was detected in 44% of the predominantly euthymic patients [ 44 ].…”

Section: Figurementioning

confidence: 99%

What Do We Know about the Long-Term Course of Early Onset Bipolar Disorder? A Review of the Current Evidence

et al. 2021

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Aim: Early onset of psychopathology is often an index of a more severe clinical course and worse prognosis. This review examined the course of bipolar disorder (BD) with onset in childhood and adolescence, with a focus on persistence of symptoms, severity of illness, comorbidity, and functional impairment. Methods: The databases of PubMed, Embase, and PsycInfo were systematically searched for publications since 1990 reporting on long-term (12 months or longer) assessments of patients with early onset BD. Results: Forty-two relevant publications were identified, which reported on data derived from 15 different patient cohorts, including 7 prospective research psychopathology studies, 4 medical record reviews, 2 follow-ups of clinical trial samples, 1 managed care database, and 1 nationwide registry, for a total of 10,187 patients. The length of follow-ups ranged from 1.0 to 15 years. Diagnostic stability of BD ranged from 73% to 100% over ten years. Recovery rate from an index episode was 81.5–100% and recurrence rate was 35–67%. Suicide attempt cumulative prevalence in five years was 18–20%. Earlier age at the first episode predicted a more severe clinical course. Conclusions: Early onset BD persists over time through adolescence, with homotypic diagnostic continuity over the years, but heterogeneity in the severity of the clinical course. Whether early identification and treatment improves distal prognosis remains to be further investigated.

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Predictors of longitudinal psychosocial functioning in bipolar youth transitioning to adults

Abstract: Objectives: In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: 1) to examine longitudinal psychosocial functioning; 2) to determine whether psychosocial Contributors

Cited by 19 publications

References 57 publications

Exploring Risk and Resilient Profiles for Functional Impairment and Baseline Predictors in a 2-Year Follow-Up First-Episode Psychosis Cohort Using Latent Class Growth Analysis

Exploring Risk and Resilient Profiles for Functional Impairment and Baseline Predictors in a 2-Year Follow-Up First-Episode Psychosis Cohort Using Latent Class Growth Analysis

Neural correlates of reward processing distinguish healthy youth at familial risk for bipolar disorder from youth at familial risk for major depressive disorder

What Do We Know about the Long-Term Course of Early Onset Bipolar Disorder? A Review of the Current Evidence

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