Long-Term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)

Perlis, Roy H.; Miyahara, Sachiko; Marangell, Lauren B.; Wisniewski, Stephen R.; Ostacher, Michael J.; DelBello, Melissa P.; Bowden, Charles L.; Sachs, Gary S.; Nierenberg, Andrew A.

doi:10.1016/j.biopsych.2004.01.022

Cited by 761 publications

(571 citation statements)

References 27 publications

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“…Compared to BPD youth without SUD, those with SUD had an older age at assessment, older age of BPD onset, adolescent-onset of their mania, higher number of yearly episodes and more conduct symptoms. In the current study the vast majority of subjects were deemed to manifest highly mixed presentations and rapid cyclingcharacteristics that had been putatively linked with SUD in adults with BPD (McElroy, et al, 2001, Perlis, et al, 2004. However, unlike in adults where mixed and highly comorbid BPD have been associated with SUD (McElroy, et al, 2001), in the current study, BPD youth with and without SUD did not differ significantly in the number of manic symptoms, BPD type, or mixed status.…”

Section: Discussionmentioning

confidence: 50%

“…Likewise, an excess of BPD has also been reported in SUD samples (Gawin and Kleber, 1986, Regier, et al, 1990, Rounsaville, et al, 1982, 1991, Weiss, et al, 1988. Data from studies of BPD adults also suggest that the risk for SUD is particularly high in those adults who had the onset of their BPD prior to age 18 years (Dunner and Feinman, 1995, Fleck, et al, 2006, Goldstein and Levitt, 2006, Lin, et al, 2006, Perlis, et al, 2004. For instance, Lin et al (2006) showed that -earlier onset BPD was associated with a higher risk for SUD in adults than later-onset (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: A controlled study

Wilens

Biederman

Adamson

et al. 2008

Drug and Alcohol Dependence

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Section: Discussionmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: A controlled study

Wilens

Biederman

Adamson

et al. 2008

Drug and Alcohol Dependence

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“…Between one‐third (community samples) and two‐thirds (clinical samples) of patients with BD experience their first mood episode during childhood or adolescence, with an earlier onset related to a more severe illness characterized by increased symptom burden and comorbidity 561, 562. In contrast to the controversies of as recently as a decade ago, there is now far greater consensus in the field that, although there are developmental differences in the manner in which symptoms manifest themselves, the actual diagnosis of BD in children and adolescents should be made based on the same set of symptoms as applied to adults 563.…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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“…Virtually every study finds a high rate of comorbidity between childhood BD and ADHD Fergus et al, 2003;Geller, Warner, Williams, & Zimerman, 1998;Perlis et al, 2004;). The significance of this overlap is uncertain, however.…”

Section: Adhd As An Early Risk Indicatormentioning

confidence: 99%

Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations

Miklowitz

Chang

2008

Dev Psychopathol

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This article examines how bipolar symptoms emerge during development, and the potential role of psychosocial and pharmacological interventions in the prevention of the onset of the disorder. Early signs of bipolarity can be observed among children of bipolar parents and often take the form of subsyndromal presentations (e.g., mood lability, episodic elation or irritability, depression, inattention, and psychosocial impairment). However, many of these early presentations are diagnostically nonspecific. The few studies that have followed at-risk youth into adulthood find developmental discontinuities from childhood to adulthood. Biological markers (e.g., amygdalar volume) may ultimately increase our accuracy in identifying children who later develop bipolar I disorder, but few such markers have been identified. Stress, in the form of childhood adversity or highly conflictual families, is not a diagnostically-specific causal agent but does place genetically and biologically vulnerable individuals at risk for a more pernicious course of illness. A preventative family-focused treatment for children with (a) at least one first-degree relative with bipolar disorder, and (b) subsyndromal signs of bipolar disorder, is described. This model attempts to address the multiple interactions of psychosocial and biological risk factors in the onset and course of bipolar disorder.

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Long-Term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)

Cited by 761 publications

References 27 publications

Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: A controlled study

Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: A controlled study

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations

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