Definitional issues in bipolar disorder across the life cycle.

Youngstrom, Eric A.

doi:10.1111/j.1468-2850.2009.01154.x

Cited by 35 publications

(34 citation statements)

References 152 publications

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“…DSM-5 does allow for a diagnosis of cyclothymic disorder, even with a history of hypomania, mania, or depressionbut only if the cyclothymic disorder came first, and if it lasted for a sufficient period of time to support that diagnosis. A good analogy would be with the concept of "double depression", where a dysthymic disorder predates the onset of a full major depressive episode (Angst, 2013;Van Meter et al, 2011;Youngstrom, 2009). In clinical practice, most cyclothymic patients are or were referred to clinical attention for major affective episodes.…”

Section: Psychopathologymentioning

confidence: 99%

Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder

Perugi

Hantouche²,

Vannucchi

et al. 2015

Journal of Affective Disorders

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Section: Psychopathologymentioning

confidence: 99%

Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder

Perugi

Hantouche²,

Vannucchi

et al. 2015

Journal of Affective Disorders

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“…Variability in the presence and salience of risk factors across clinical populations and age groups may complicate attempts at targeted prevention. This is particularly true for children with PBD; core symptoms and psychosocial impairment are highly heterogeneous and vary across pediatric- versus later adolescent- or adult-onset bipolar disorder (Akiskal, 1995; Youngstrom, 2009), making it difficult to understand risk processes related to suicide.…”

Section: Introductionmentioning

confidence: 99%

Cognitive and family correlates of current suicidal ideation in children with bipolar disorder

Weinstein

Meter

Katz

et al. 2015

Journal of Affective Disorders

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Background Suicidality among youth with bipolar disorder is an extreme, but largely unaddressed, public health problem. The current study examined the psychosocial characteristics differentiating youth with varying severities of suicidal ideation that may dictate targets for suicide prevention interventions. Methods Participants included 72 youth aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or NOS and a parent/caregiver. Current suicidal ideation and correlates were assessed at intake, including: demographics and clinical factors (diagnosis, symptom severity, psychiatric comorbidity); child factors (cognitive risk and quality of life); and family factors (parenting stress, family cohesion, and family rigidity). Results Current ideation was prevalent in this young sample: 41% endorsed any ideation, and 31% endorsed active forms. Depression symptoms, quality of life, hopelessness, self-esteem, and family rigidity differentiated youth with increasing ideation severity. Separate logistic regressions examined all significant child- and family-level factors, controlling for demographic and clinical variables. Greater family rigidity and lower self-esteem remained significant predictors of current planful ideation. Diagnosis, index episode, comorbidity, and mania severity did not differentiate non-ideators from those with current ideation. Limitations Limitations include the small sample to examine low base-rate severe ideation, cross-sectional analyses and generalizability of findings beyond the outpatient clinical sample. Conclusions Findings underscore the importance of assessing and addressing suicidality in preadolescent youth with bipolar disorder, before youth progress to more severe suicidal behaviors. Results also highlight child self-esteem and family rigidity as key treatment targets to reduce suicide risk in pediatric bipolar disorder.

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“…Given the degree of specificity (i.e., must have both hypomanic and depressive symptoms for at least one year, without ever having met criteria for a hypomanic, manic, or depressive episode) and the need for long-term (one year+) retrospective recall (American Psychiatric Association, 2013), accurately making this diagnosis requires a lot of attention to detail from clinicians and informants. Consequently, other diagnostic categories (e.g., BP-NOS) tend to be used instead (Jensen-Doss et al, 2014; Youngstrom, 2009). An accurate diagnosis can make a significant difference in the outcomes a young person can achieve by guiding personalized, evidence-based intervention.…”

mentioning

confidence: 99%

Longitudinal course and characteristics of cyclothymic disorder in youth

Meter

Youngstrom

Birmaher

et al. 2017

Journal of Affective Disorders

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Objectives Epidemiological studies suggest that cyclothymic disorder is the most prevalent subtype of bipolar disorder (BD). However, it is rarely diagnosed, especially in youth. This may be because it can be difficult to ascertain whether a youth meets diagnostic criteria. Clearer, easy-to-apply criteria could reduce misdiagnosis. The objective of this study was to determine whether proposed research diagnostic criteria for cyclothymic disorder (RDCyc), based on DSM-5 criteria, could be quantified and validated in youth. Methods Participants from the Longitudinal Assessment of Manic Symptoms (LAMS) study were recruited based on symptoms of mania and followed prospectively. RDCyc criteria were: 1) At least one core symptom each of mania and depression; 2) one additional symptom of mania and of depression; 3) persistence over two consecutive six-month periods, and 4) impairment. Exclusionary criteria were having a [hypo]manic or depressive episode. Outcomes at the two-year follow-up were compared between RDCyc youth and other diagnostic groups (BD I/II, BD NOS/non-RDCyc cyclothymic disorder, disruptive behavior disorders [DBD], depression). Results Thirty-seven youth met RDCyc criteria. There were no consistent differences between the RDCyc youth and youth with other BD subtypes (ps=.001–.960, with all-but-one p value >.02). RDCyc youth had higher depression (p<.0005) and mania scores (p=.001), lower functioning (p=.012), and higher suicide risk than DBD youth (p=.001). They had higher mania scores than depressed youth (p.018). Limitations The majority of youth in the sample were recruited due to elevated symptoms of mania, which may limit the generalizability of the results. Youth were followed for two years, which may not be long enough to determine whether or not they will eventually develop a manic or depressive episode. Conclusions Applying RDCyc criteria identified youth who were similar to others with BD and were more impaired than those with DBD. Using these criteria could reduce misdiagnosis and increase our understanding of this prevalent, but largely ignored, diagnosis.

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Definitional issues in bipolar disorder across the life cycle.

Cited by 35 publications

References 152 publications

Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder

Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder

Cognitive and family correlates of current suicidal ideation in children with bipolar disorder

Longitudinal course and characteristics of cyclothymic disorder in youth

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