People who develop bipolar disorder in childhood or adolescence are at greater risk for recurrence, chronicity of mood symptoms, and functional impairment than those who develop the mood disorder in adulthood, US study results confirm.

“Symptoms of bipolar disorder are increasingly recognized among children and adolescents,” explain Roy Perlis (Massachusetts General Hospital and Harvard Medical School, Boston, USA), and colleagues.

But they add: “Little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms.”

To investigate, the researchers studied data on 3658 adult patients with bipolar I and II disorder who were participating the Systematic Treatment Enhancement Program for Bipolar Disorder ??” a multicenter clinical effectiveness study.

The participants were divided into three groups based on age at disease onset of less than 13 years (childhood or prepubertal onset), 13??”18 years (adolescent onset) and over 18 years (adult onset).

Baseline features and outcomes over 2 years of follow-up were compared among the three groups.

The team found that, compared with the 1187 patients with adult onset bipolar disorder, the 1068 patients with childhood or prepubertal onset of disease experienced, on average, an earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over follow-up.

Patients with adolescent onset bipolar disorder (n=1403) also had poorer outcomes than those with adult-onset disease, but better outcomes than those with childhood or prepubertal onset bipolar disorder.

Writing in the journal Bipolar Disorders, Perlic and team conclude: “These results… suggest that individuals with earlier onset [bipolar disorder] may be at risk for a more chronic as well as recurrent course in adulthood, with poorer functioning and quality of life.”

They add that the findings “underscore the need to develop better strategies for early identification and early interventions which achieve and maintain symptomatic remission and enhance functioning over the course of development.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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