Prevalence and Socio-Demographic Factors of Bipolar Mood Disorders in Children and Adolescents: Identifying the Principal Predictors

Abstract

Objectives: Our objective is to measure the prevalence of bipolar mood disorder (BMD) in Iranian children and adolescents and its comorbidity with psychiatric disorders. Also, the main purpose of this study is to characterize the main risk factors for BMD in children and adolescents. Methods: This is an analytical cross-sectional study. In a community-based study, we sampled 1000 children and adolescents from the age of 6 to 18 years in each province via the multistage cluster sampling method. The total valid sample size reached 29 812 cases. The instructed clinical psychologists completed the Persian version of the kiddie schedule for affective disorders and schizophrenia present and lifetime version (K-SADS-PL). Furthermore, the demographic data were obtained. To analyze the data, descriptive statistics, multinomial, and multiple logistic regressions were utilized to evaluate the relationships. Results: The total prevalence rates for BMD were 0.29%; it was 0.26% in males and 0.29% in females. BMD rates were larger in children and adolescents whose mothers had an occupation. Also, after controlling the effective variables (sex and age), location (rural or urban), the father’s education, and the psychiatric hospitalization of the mother or the father, none predicted BMD significantly. Moreover, patients with comorbidities showed a superior prevalence compared to those without comorbidities, ranging from 1.96% for posttraumatic stress disorder to 39.22% for the oppositional defiant disorder. Conclusion: BMD was more prevalent among women. The gender or the father’s education level was not the risk factor for BMD symptoms. Several factors, such as maternal education and maternal job were also important for the prevalence of BMD symptoms.

The diagnosis of bipolar disorder in children and adolescents: Past, present and future

“…Beginning with the most conservative reports in recent years, studies conducted in Oman and Iran found rates of BD in children and adolescents as low as 0.29% 7 and up to 0.8% 8 and 1% 9 . Earlier research conducted in the United States has reported similar rates between 0.5% (rates of Bipolar I disorder) and 1.0%, and thus at first pass these recent figures seem reassuring and predictably, when bipolar spectrum disorders are included (6.6%) 10 or the illness is subsumed within a broader ‘category’ such as, emotional disorders, its reported prevalence (7.4%) is much higher; 11 underscoring the point that the instrument used to ‘capture’ the disorder is critical in determining its definition.…”

“… ‡ ‡ The desire for making the diagnosis as early as possible understandable and early diagnosis has been driven by the early intervention movement, which started in schizophrenia/psychosis and has been adopted by those managing mood disorders. However, these paradigms are predicated on significant assumptions, many of which have been challenged 7,27,28 …”

Differential Diagnosis of Attention-Deficit/Hyperactivity Disorder and Bipolar Disorder using Steady-State Visual Evoked Potentials

“…It is difficult for psychiatrists to separate these two patient groups based on clinical observations, at least in the initial interview sessions [8]. The prevalence of bipolar disorder at young ages is low, so this disorder is proposed for children as a secondary diagnosis next to ADHD [9]. A previous study showed that 28.6% of patients with bipolar disorder are misdiagnosed as ADHD [10], [11].…”