Recovery and Relapse in Adolescents with Bipolar Affective Illness: A Five-Year Naturalistic, Prospective Follow-up

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

“…Likewise, outpatient adolescents with BPD were previously found to be at heightened risk for the development of SUD relative to non-BPD psychiatric controls (Wilens, et al, 1999). Strober et al (1995) reported that five years after hospitalization, 22% of adolescents with BPD had SUD, though no further description of the SUD or comparison with controls were available. More recently, Axelson et al (2006) reported a 10% rate of SUD in a younger sample of BPD although no control groups were available for comparison.…”

Decreased Anterior Cingulate Myo-inositol/Creatine Spectroscopy Resonance with Lithium Treatment in Children with Bipolar Disorder

“…Open-label (Hsu 1986;Carlson et al 1992;Strober et al 1995), and one doubleblind placebo-controlled study of adolescents with substance abuse and mania (Geller et al 1998) suggest that juveniles with BPD may have somewhat reduced benefit from acute lithium therapy compared with adults. Nevertheless, lithium continues to be widely prescribed among children and adolescents with BPD (Geller and Luby 1997) as well as for young patients presenting with excessive irritability (Fava 1997) and extreme affective dysregulation (Vitiello and Stoff 1997).…”

“…4 magnetic resonance of myo-inositol in the anterior cingulate cortex in children with BPD, as measured by in vivo proton magnetic resonance spectroscopy ( 1 H MRS). Secondarily, we postulated that a decrease in myo-inositol signal in response to lithium might be a predictor of treatment efficacy.Lithium has traditionally been the preferred treatment of the manic phase of bipolar illness in adults, children (Geller and Luby 1997), and adolescents (Strober et al 1995) with BPD. Open-label (Hsu 1986;Carlson et al 1992;Strober et al 1995), and one doubleblind placebo-controlled study of adolescents with substance abuse and mania (Geller et al 1998) suggest that juveniles with BPD may have somewhat reduced benefit from acute lithium therapy compared with adults.…”

Phenomenology, socio-demographic factors and outcome upon discharge of manic and mixed episodes in hospitalized adolescents

“…Depressive episodes were the most frequent diagnoses in past psychiatric history (42.2%). This is not surprising as it had been reported that 20-30% of depressed children, particularly those with psychosis, a family history of BD and/or pharmacologically induced mania, eventually develop BD [17,22,51,52,57]. Interestingly, 16% had a previous history of brief psychotic episode, indicating that in youth first episode of bipolarity may be non-specific to mood disorders.…”

“…To summarize, mixed polarity, low socioeconomic status (SES), young age at onset, previous affective episode, psychosis and female sex were associated at least in one study with a poorer outcome [5,18,27,29,52]. Furthermore, in the US, inpatient treatment tends to be shorter and shorter (median lenght of stay for BD in 2000 is 5.6 days) due to economic pressures [12], which leads to a bias in short-term prognosis studies.…”