Delayed treatment of childhood-onset bipolar disorder results in negative outcome in adults

In bipolar disorder, also called manic-depressive disorder, a person experiences mood changes that fluctuate between periods of abnormally high energy and extreme depression. Bipolar disorder is estimated to affect approximately 1-3% of adults, but also can affect children and adolescents. Untreated, this disorder is associated with greater risk of drug and alcohol addiction, of interpersonal relationship difficulties, of school and, later, work problems, of engaging in risky behaviors, and of suicide. A study published in the May issue of The Journal of Pediatrics shows that childhood-onset bipolar disorder is more common than believed and often goes unrecognized and untreated for long periods of time, leading to lower quality of life and greater difficulty in treatment.

480 adults in the United States who were diagnosed with bipolar disorder completed questionnaires and were interviewed about their courses of illness. These adults were studied at an average age of 42 and had been ill for an average time of more than 20 years. Researchers from the National Institute of Mental Health of the National Institutes of Health and from other institutions determined the age of onset of manic or depressive symptoms and the age of first treatment in this group. The duration of time from onset of illness to first pharmacological treatment for depression or mania was available for 420 patients. For those who experienced the onset of bipolar disorder in childhood (under 13 years old), the average time before first treatment was more than 16 years (Figure). They experienced more days depressed, more days in which both mania and depression occurred within a 24-hour period (ultradian cycling), and greater number of manic and depressive episodes throughout their lives. The patients also had an increased risk of substance abuse, a greater lifetime risk of suicide attempts, higher prevalence of lifetime anxiety disorders, and greater resistance to treatment. '"/>

Contact: Alice M. Landwehr
Elsevier Health Sciences

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