Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder

Meter, Anna Van; Moreira, Ana Lúcia R.; Youngstrom, Eric A.

doi:10.4088/jcp.18r12180

Cited by 102 publications

(46 citation statements)

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“…This finding is controversial to findings of Dickstein 2005 , where chronic irritability experiencing broad phenotype patients were diagnosed with less anxiety disorders. On the other hand, use of broad definition criteria for PBD leads to almost 2.5 times higher prevalence for individuals diagnosed with PBD . Broad definition of PBD includes chronic irritability and mood lability, but not necessarily apparent mood episodes.…”

Section: Discussionsupporting

confidence: 92%

“…Despite the fact that the phenomenology and comorbidities of PBD are more complex and that the prognosis is worse , there are fewer studies on PBD than there are on adults with BD. The number of published studies on PBD has increased lately, but this has not resolved quandaries of phenomenology and variations in PBD . Most of our knowledge about bipolar disorder comes from studies on adults, which limits the understanding of pediatric bipolar disorder and early‐onset BD.…”

Section: Introductionmentioning

confidence: 99%

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Anxiety disorders comorbidity in pediatric bipolar disorder: a meta‐analysis and meta‐regression study

Eser

Taskiran

Ertinmaz

et al. 2020

Acta Psychiatr Scand

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Objective Anxiety disorders (AD) are known for its comorbidity and negative impact on the course of adult bipolar disorder (BD). However, there is limited research on AD comorbidity in pediatric BD (PBD). Here, we aimed to conduct a meta‐analysis and meta‐regression study about the comorbidity and covariates of AD and PBD. Method We systematically searched relevant articles published until May 2019, as defined in PRISMA guidelines. Variables for associated features and prevalence of AD were extracted. Results Thirty‐seven articles represented data for the analysis. Lifetime any AD comorbidity was 44.7%; panic disorder (PD) was 12.7%; generalized anxiety disorder (GAD) was 27.4%; social phobia was 20.1%; separation anxiety disorder (SAD) was 26.1%; and obsessive–compulsive disorder (OCD) was 16.7%. Childhood‐onset studies reported higher GAD and SAD comorbidity, while adolescent‐onset studies reported higher PD, OCD, and social phobia. Age of onset, gender, comorbidity of ADHD, substance use, oppositional defiant disorder and conduct disorder affected each anxiety disorders’ comorbidity with PBD differently. Conclusion Anxiety disorders are highly comorbid with PBD. Early‐onset PBD increases the risk of AD. Biopsychosocial aspects of this comorbidity and its course needs to be evaluated further.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Anxiety disorders comorbidity in pediatric bipolar disorder: a meta‐analysis and meta‐regression study

Eser

Taskiran

Ertinmaz

et al. 2020

Acta Psychiatr Scand

View full text Add to dashboard Cite

show abstract

“…Prior to this, children in the UK without a diagnosis of ADHD were disadvantaged, suffering unnecessary and damaging family conflicts, disrupted school careers, and many ending up wrongly in juvenile justice system. In the case of PBD we showed (James et al 2014) a remarkable-72 fold difference in hospital admission rates between England and the US, which appeared to be due to hospital diagnostic practices, as meta-analyses of epidemiological populations surveys showed a consistency between countries when using narrow, rather than broad, diagnostic criteria (Meter et al 2019).…”

mentioning

confidence: 72%

Reflections on: "The diagnosis of bipolar disorder in pre-pubertal children—what was the controversy about and what did we learn as a result?"

James

2020

Int J Bipolar Disord

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“…In addition, no cases of mania were found in a British clinic survey of 2500 children aged 10 and under (Harrington and Myatt 2003) and only one child met diagnostic criteria for both ICD-10 hypomania and DSM-IV bipolar disorder NOS in a UK sample of 200 young people with ADHD (6-18 years, mean age 11.15) (Hassan et al 2011). A recent meta-analysis re-examined prevalence rates of paediatric bipolar disorder in epidemiological samples (Van Meter et al 2019). The authors concluded that there was no difference in rates of paediatric bipolar disorder in the US compared to other countries based on data from structured interviews in epidemiological populations.…”

Section: Cross-national Differencesmentioning

confidence: 99%

Pre-pubertal bipolar disorder: origins and current status of the controversy

Duffy

Carlson

Dubicka

et al. 2020

Int J Bipolar Disord

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Background: Evidence from epidemiological, clinical and high-risk studies has established that the peak period of risk for onset of bipolar disorder spans late adolescence and early adulthood. However, the proposal of the existence of a pre-pubertal form of bipolar disorder manifesting in early childhood created substantial debate. In this narrative review, the literature and contributing factors pertaining to the controversy surrounding the proposed pre-pubertal bipolar disorder subtype are discussed. The resolution of the debate and lessons learned are highlighted. Main body: In the mid 1990s US researchers proposed that chronic irritability and explosive temper in pre-pubertal children with pre-existing ADHD and/or other learning and developmental disorders might represent a variant of mania. A number of factors contributed to this proposal including severely ill children with no diagnostic home given changes in the ADHD DSM diagnostic criteria and over-reliance on symptoms and structured interviews rather than on a clinical assessment incorporating developmental history, social context and clinical course. Prospective studies of children at high familial risk did not support the proposed pre-pubertal bipolar phenotype; but rather provided convergent evidence that bipolar disorder onset in adolescence and early adulthood not uncommonly preceded by sleep and internalizing symptoms and most often debuting as depression in adolescence (after puberty). Epidemiological studies of population and hospital discharge data provided evidence that the pre-pubertal bipolar phenotype was largely a US driven phenomenon. Conclusions: Psychiatric diagnosis is particularly challenging given the current lack of objective biomarkers. However, validity and utility of clinical diagnoses can be strengthened if all available predictive information is used to formulate a diagnosis. As in other areas of medicine, critical information required to make a valid diagnosis includes developmental history, clinical course, family history and treatment response-weighed against the known trajectories of classical disorders. Moreover, given that psychiatric disorders are in evolution over childhood and adolescence and symptoms, in of themselves, are often non-specific, a thorough clinical assessment incorporating collateral history and psychosocial context is paramount. Such an approach might have avoided or at least brought a more timely resolution to the debate on pre-pubertal mania.

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Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder

Cited by 102 publications

References 0 publications

Anxiety disorders comorbidity in pediatric bipolar disorder: a meta‐analysis and meta‐regression study

Anxiety disorders comorbidity in pediatric bipolar disorder: a meta‐analysis and meta‐regression study

Reflections on: "The diagnosis of bipolar disorder in pre-pubertal children—what was the controversy about and what did we learn as a result?"

Pre-pubertal bipolar disorder: origins and current status of the controversy

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