Bipolar disorders during adolescence.

Area of Science:

• Child and Adolescent Psychiatry
• Mood Disorders Research
• Mental Health Epidemiology

Background:

• Bipolar disorder (BD) and subthreshold presentations are significant concerns in adolescent mental health.
• Understanding the early course and familial patterns of these conditions is vital for effective intervention.

Purpose of the Study:

• To investigate the incidence, associated factors, progression, and family history of bipolar disorder (BD) and subthreshold BD in adolescents.
• To identify early indicators and long-term outcomes for adolescent BD spectrum disorders.

Main Methods:

• Utilized structured diagnostic interviews in a large community sample of adolescents and their first-degree relatives.
• Conducted longitudinal re-evaluations of adolescents into young adulthood to track disorder progression.

Main Results:

• Onset of BD and subthreshold BD predominantly occurred during adolescence, correlating with increased impairment, comorbidity, and suicide attempts.
• Adolescents diagnosed with BD faced higher risks for developing BD in adulthood, while those with subthreshold BD were at increased risk for major depressive disorder (MDD).
• Family history revealed elevated rates of subthreshold BD and MDD in relatives of adolescents with BD, and vice versa for relatives of those with subthreshold BD.

Conclusions:

• Evidence confirms the existence of 'classical' bipolar disorder in adolescence, alongside a spectrum of milder bipolar conditions.
• Addressing and preventing adolescent BD and related disorders is a critical public health priority requiring focused attention and resources.