A Cohort Study of the Prevalence and Impact of Comorbid Medical Conditions in Pediatric Bipolar Disorder

Jerrell, Jeanette M.; McIntyre, Roger S.; Tripathi, Avnish

doi:10.4088/jcp.09m05585ora

Cited by 97 publications

(90 citation statements)

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“…The lack of evidence for an association between atopic illness and hypomanic symptoms is surprising given a number of cross-sectional studies (Goodwin et al 2003;Beyer et al 2005;Jerrell et al 2010) and longitudinal studies (Liang & Chikritzhs, 2013;Chen et al 2014;Lin et al 2014) have reported an association between asthma and bipolar disorder. This may be because previous studies have examined the severe end of the bipolar spectrum (hospitalization for bipolar disorder) and this association may not hold when our broad definition of hypomania is used.…”

Section: Discussionmentioning

confidence: 99%

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Hayes¹,

Khandaker²,

Anderson³

et al. 2017

Psychol. Med.

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Background. There are no existing longitudinal studies of inflammatory markers and atopic disorders in childhood and risk of hypomanic symptoms in adulthood. This study examined if childhood: (1) serum interleukin-6 (IL-6) and C-reactive protein (CRP); and (2) asthma and/or eczema are associated with features of hypomania in young adulthood.Method. Participants in the Avon Longitudinal Study of Parents and Children, a prospective general population UK birth cohort, had non-fasting blood samples for IL-6 and CRP measurement at the age of 9 years (n = 4645), and parents answered a question about doctor-diagnosed atopic illness before the age of 10 years (n = 7809). These participants completed the Hypomania Checklist at age 22 years (n = 3361).Results. After adjusting for age, sex, ethnicity, socio-economic status, past psychological and behavioural problems, body mass index and maternal postnatal depression, participants in the top third of IL-6 values at 9 years, compared with the bottom third, had an increased risk of hypomanic symptoms by age 22 years [adjusted odds ratio 1.77, 95% confidence interval (CI) 1.10-2.85, p < 0.001]. Higher IL-6 levels in childhood were associated with adult hypomania features in a dose-response fashion. After further adjustment for depression at the age of 18 years this association remained (adjusted odds ratio 1.70, 95% CI 1.03-2.81, p = 0.038). There was no evidence of an association of hypomanic symptoms with CRP levels, asthma or eczema in childhood.Conclusions. Higher levels of systemic inflammatory marker IL-6 in childhood were associated with hypomanic symptoms in young adulthood, suggesting that inflammation may play a role in the pathophysiology of mania. Inflammatory pathways may be suitable targets for the prevention and intervention for bipolar disorder.

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Section: Discussionmentioning

confidence: 99%

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Hayes¹,

Khandaker²,

Anderson³

et al. 2017

Psychol. Med.

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“…Psychotic symptoms have been reported in about one-third of youth with BD, and confer a significantly greater likelihood of lifetime GAD, agoraphobia, social phobia, and obsessive compulsive disorder (OCD) (236). Medical comorbidities including obesity, type 2 diabetes mellitus, other endocrine disorders, migraine headaches, central nervous system disorders ⁄ epilepsy, organic brain disorders ⁄ mental retardation, cardiovascular disorders, and asthma in a large cohort study were significantly more prevalent among children and adolescents with BD (n = 1841) compared to a control group (n = 4500) (237). In the COBY study (n = 348), overweight ⁄ obesity was seen in 42% of youth with BD, and was associated with increased psychiatric burden (238).…”

Section: Comorbidities and Mimicsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

et al. 2012

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Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O’Donovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M.  Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.  Bipolar Disord 2012: 00: 000–000. © 2012 John Wiley & Sons A/S.Published by Blackwell Publishing Ltd.The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications.The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, and several atypical antipsychotic agents continue to be first‐line treatments for acute mania. Monotherapy with asenapine, paliperidone extended release (ER), and divalproex ER, as well as adjunctive asenapine, have been added as first‐line options.For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, as well as olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first‐line options. Lurasidone monotherapy and the combination of lurasidone or lamotrigine plus lithium or divalproex have been added as a second‐line options. Ziprasidone alone or as adjunctive therapy, and adjunctive levetiracetam have been added as not‐recommended options for the treatment of bipolar depression. Lithium, lamotrigine, valproate, olanzapine, quetiapine, aripiprazole, risperidone long‐acting injection, and adjunctive ziprasidone continue to be first‐line options for maintenance treatment of bipolar disorder. Asenapine alone or as adjunctive therapy have been added as third‐line options.

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“…58 Moreover, these conditions, including obesity and T2DM, were found to precede diagnoses of BD. 54 Similarly, research based on medical claims data indicated that children and adolescents diagnosed with BD were more likely to access several medical services, including cardiology services. 55 Finnish population-based prospective data indicated that there was a bidirectional association between depressive symptoms and MetS between childhood (mean age, 12 years) and early adulthood (mean age, 33 years).…”

Section: Traditional Cardiovascular Risk Factors In Relation To Mdd Amentioning

confidence: 99%

“…[53][54][55][56][57] No published study could be identified that primarily sought to determine the prevalence of MetS in a pediatric MDD or BD population. Notwithstanding this, data from the South Carolina Medicaid program, covering all medical services and medication prescriptions between January 1996 and December 2005, indicated that children and adolescents with BD are differentially affected by several medical disorders, including but not limited to obesity and T2DM.…”

Section: Traditional Cardiovascular Risk Factors In Relation To Mdd Amentioning

confidence: 99%

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

Goldstein¹,

Carnethon²,

Matthews³

et al. 2015

Circulation

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382

282

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Abstract-In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children andAdolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2)

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A Cohort Study of the Prevalence and Impact of Comorbid Medical Conditions in Pediatric Bipolar Disorder

Cited by 97 publications

References 0 publications

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

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