TY - JOUR
T1 - Distinguishing young people with emerging bipolar disorders from those with unipolar depression
AU - Scott, Elizabeth M.
AU - Hermens, Daniel F.
AU - Naismith, Sharon L.
AU - Guastella, Adam J.
AU - De Regt, Tamara
AU - White, Django
AU - Lagopoulos, Jim
AU - Hickie, Ian B.
PY - 2013/1/25
Y1 - 2013/1/25
N2 - Background: To facilitate early intervention, there is a need to distinguish unipolar versus bipolar illness trajectories in adolescents and young adults with adult-type mood disorders. Methods: Detailed clinical and neuropsychological evaluation of 308 young persons (aged 12 to 30 years) with moderately severe unipolar and bipolar affective disorders. Results: Almost 30% (90/308) of young people (mean age=19.4±4.4 yr) presenting for care with affective disorders met criteria for a bipolar-type syndrome (26% with bipolar I). Subjects with bipolar- and unipolar-type syndromes were of similar age (19.8 vs. 19.2 yr) and reported comparable ages of onset (14.5 vs. 14.3 yr). Clinically, those subjects with unipolar and bipolar-type disorders reported similar levels of psychological distress, depressive symptoms, current role impairment, neuropsychological dysfunction and alcohol or other substance misuse. Subjects with unipolar disorders reported more social anxiety (p<0.01). Subjects with bipolar disorders were more likely to report a family history of bipolar (21% vs. 11%; [χ2=4.0, p<.05]) or psychotic (19% vs. 9%; [χ2=5.5, p<.05]), or substance misuse (35% vs. 23%; [χ2=3.9, p<.05]), but not depressive (48% vs. 53%; χ2=0.3, p=.582]) disorders. Conclusions: Young subjects with bipolar disorders were best discriminated by a family history of bipolar, psychotic or substance use disorders. Early in the course of illness, clinical features of depression, or neuropsychological function, do not readily differentiate the two illness trajectories.
AB - Background: To facilitate early intervention, there is a need to distinguish unipolar versus bipolar illness trajectories in adolescents and young adults with adult-type mood disorders. Methods: Detailed clinical and neuropsychological evaluation of 308 young persons (aged 12 to 30 years) with moderately severe unipolar and bipolar affective disorders. Results: Almost 30% (90/308) of young people (mean age=19.4±4.4 yr) presenting for care with affective disorders met criteria for a bipolar-type syndrome (26% with bipolar I). Subjects with bipolar- and unipolar-type syndromes were of similar age (19.8 vs. 19.2 yr) and reported comparable ages of onset (14.5 vs. 14.3 yr). Clinically, those subjects with unipolar and bipolar-type disorders reported similar levels of psychological distress, depressive symptoms, current role impairment, neuropsychological dysfunction and alcohol or other substance misuse. Subjects with unipolar disorders reported more social anxiety (p<0.01). Subjects with bipolar disorders were more likely to report a family history of bipolar (21% vs. 11%; [χ2=4.0, p<.05]) or psychotic (19% vs. 9%; [χ2=5.5, p<.05]), or substance misuse (35% vs. 23%; [χ2=3.9, p<.05]), but not depressive (48% vs. 53%; χ2=0.3, p=.582]) disorders. Conclusions: Young subjects with bipolar disorders were best discriminated by a family history of bipolar, psychotic or substance use disorders. Early in the course of illness, clinical features of depression, or neuropsychological function, do not readily differentiate the two illness trajectories.
KW - Bipolar
KW - Family history
KW - Neuropsychology
KW - Unipolar
KW - Youth
UR - http://www.scopus.com/inward/record.url?scp=84870561375&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2012.06.031
DO - 10.1016/j.jad.2012.06.031
M3 - Article
C2 - 22877963
AN - SCOPUS:84870561375
VL - 144
SP - 208
EP - 215
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
IS - 3
ER -