Examining the association between pediatric bipolar disorder and anxiety disorders in psychiatrically referred children and adolescents

Harpold, Terri L.; Wozniak, Janet; Kwon, Anne; Gilbert, Jennifer; Wood, Julia; Smith, Laura; Biederman, Joseph

doi:10.1016/j.jad.2005.05.016

Cited by 49 publications

(38 citation statements)

References 33 publications

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“…Birmaher and colleagues (2002) have suggested that panic disorder may be specifically associated with BD among youth, however other studies have reported high rates of a variety of anxiety disorders among youth with BD (Dickstein et al, 2005;Harpold et al, 2005). Kessler and colleagues (1997) examined the association of antecedent anxiety disorders with later BD using data from the National Comorbidity Survey, and found that anxiety disorders, particularly generalized anxiety disorder and panic disorder, confer an exceedingly high risk of subsequent BD.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of bipolar I disorder among adults with primary youth‐onset anxiety disorders

Goldstein

Levitt

2007

Journal of Affective Disorders

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Objectives-It is of potentially great public health importance to determine whether youth-onset anxiety disorders are associated with increased prevalence of subsequent bipolar I disorder (BD) among adults, and to identify risk factors for BD in this population. Methods-The 2001-2002National Epidemiologic Survey on Alcohol and Related Conditions was used to identify respondents with social phobia, panic disorder, or generalized anxiety disorder that onset in youth (<19 years) and was not preceded by a major depressive, manic, or mixed episode (N=1,571; 572 males, 999 females). The prevalence of BD among subjects with, versus without, these youth-onset anxiety disorders was examined. Variables that could be associated with increased risk of BD among subjects with youth-onset anxiety disorders were examined, including conduct disorder, youth-onset substance use disorders (SUD), and family history of depression and/or alcoholism. Analyses were computed separately for males and females.Results-The prevalence of BD was significantly greater among adults with, versus without, primary youth-onset anxiety disorders for both males (15.9% vs 2.7%; χ2=318.4, df=1, p<0.001) and females (13.8% vs 2.9%; χ2=346.2, df=1, p<0.001). Youth-onset anxiety disorders remained significantly associated with BD after controlling for interceding major depression, and this was true for each of the specific anxiety disorders examined. Among males with youth-onset primary anxiety disorders, conduct disorder and loaded family history of depression were associated with significantly increased risk of BD. Among females, conduct disorder and loaded family history of alcoholism were associated with significantly increased risk of BD.Conclusions-The prevalence of BD was elevated among subjects with youth-onset primary anxiety disorders, particularly if comorbid conduct disorder was present. Future studies are needed to confirm these findings prospectively, and to develop preventive strategies for populations at risk.

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Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of bipolar I disorder among adults with primary youth‐onset anxiety disorders

Goldstein

Levitt

2007

Journal of Affective Disorders

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“…Patients with bipolar disorder are found to have far higher incidences of anxiety-related traits (Cosoff and Julian Hafner 1998;Boylan et al 2004;Harpold et al 2005), and there is a strong association between the two (often .50% of bipolar patients have diagnosed anxiety disorders; for example, see Faraone et al 1997). The link between schizophrenia and anxietyrelated disorders is more complex, although several studies have shown a correlation between anxiety and both the negative symptoms (Kulhara et al 1989;Sax et al 1996;Norman et al 1998;Huppert et al 2001) and the positive symptoms (Norman and Malla 1991;Huppert et al 2001) associated with schizophrenia.…”

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confidence: 99%

Genetical Genomics of Behavior: A Novel Chicken Genomic Model for Anxiety Behavior

et al. 2015

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The identification of genetic variants responsible for behavioral variation is an enduring goal in biology, with wide-scale ramifications, ranging from medical research to evolutionary theory on personality syndromes. Here, we use for the first time a largescale genetical genomics analysis in the brains of chickens to identify genes affecting anxiety as measured by an open field test. We combine quantitative trait locus (QTL) analysis in 572 individuals and expression QTL (eQTL) analysis in 129 individuals from an advanced intercross between domestic chickens and Red Junglefowl. We identify 10 putative quantitative trait genes affecting anxiety behavior. These genes were tested for an association in the mouse Heterogeneous Stock anxiety (open field) data set and human GWAS data sets for bipolar disorder, major depressive disorder, and schizophrenia. Although comparisons between species are complex, associations were observed for four of the candidate genes in mice and three of the candidate genes in humans. Using a multimodel approach we have therefore identified a number of putative quantitative trait genes affecting anxiety behavior, principally in chickens but also with some potentially translational effects as well. This study demonstrates that chickens are an excellent model organism for the genetic dissection of behavior.

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“…Pediatric bipolar disorder is a highly co-morbid condition (Kowatch et al 2005a) with high rates of conduct disorder (Biederman et al 1999;Wozniak et al 2001), anxiety disorders (Birmaher et al 2002;Wozniak et al 2002;Harpold et al 2005;Masi et al 2007), and attention-deficit=hyperactivity disorder (ADHD) (Borchardt and Bernstein 1995;Geller et al 1995;Lewinsohn et al 1995;Biederman et al 1996;West et al 1995a;West et al 1995b;Wozniak et al 1995;Wozniak and Biederman 1996;Post et al 2004;Reich et al 2005), all of which might be responsive to additional pharmacological intervention.…”

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confidence: 99%

Prescribing Patterns for Treatment of Pediatric Bipolar Disorder in a Specialty Clinic

Potter

Liu

Monuteaux

et al. 2009

Journal of Child and Adolescent Psychopharmacology

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Objective: The aim of this study was to describe prescribing practices in the treatment of pediatric bipolar disorder in a university practice setting. Method: A retrospective chart review was performed on 53 youths diagnosed using Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV), criteria with bipolar spectrum disorder under the active care of child psychiatrists practicing in a pediatric psychopharmacology specialty clinic. Current medications, doses, and related adverse events were recorded. Clinicians were asked to provide a target disorder (bipolar mania=mixed state, depression, attention deficit hyperactivity disorder [ADHD], or anxiety) for each medication to the best of their ability. The Clinical Global ImpressionsSeverity (CGI-S) scale was used to measure severity of each disorder before treatment and the Clinical Global ImpressionsImprovement (CGI-I) was used to quantify the magnitude of improvement with treatment. Meaningful improvement of the disorder was defined by CGI-I score of 1 or 2. Results: The mean number of psychotropic medications per patient was 3.0 AE 1.6. A total of 68% of patients were treated for co-morbid disorders; 23% of patients were treated with monotherapy, primarily with second-generation antipsychotics. Mania improved in 80% of cases, mixed state improved in 57% of cases, ADHD improved in 56% of cases, anxiety improved in 61% of cases, and depression improved in 90% of cases. Conclusion: The management of pediatric bipolar disorder often requires multiple medications. For the treatment of mania= mixed states, clinicians prescribed second-generation antipsychotics more frequently than mood stabilizers, especially in the context of monotherapy. Co-morbidity was a frequent problem with moderate success obtained with combined pharmacotherapy approaches. Further psychosocial strategies to augment pharmacotherapy may improve outcome while reducing the medication burden in pediatric bipolar disorder.

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Examining the association between pediatric bipolar disorder and anxiety disorders in psychiatrically referred children and adolescents

Cited by 49 publications

References 33 publications

Prevalence and correlates of bipolar I disorder among adults with primary youth‐onset anxiety disorders

Prevalence and correlates of bipolar I disorder among adults with primary youth‐onset anxiety disorders

Genetical Genomics of Behavior: A Novel Chicken Genomic Model for Anxiety Behavior

Prescribing Patterns for Treatment of Pediatric Bipolar Disorder in a Specialty Clinic

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