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January 2011



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By Jessica Ward Jones, MD, MPH Associate News Editor
Reviewed by John M. Grohol, Psy.D. on July 28, 2010 

People with bipolar disorder whose symptoms began in childhood have a worse prognosis as adults.

The earlier in life an individual’s bipolar symptoms appear, and the longer the illness goes undiagnosed and untreated, the more severe the illness seems to be throughout life.

According to Dr. Robert M. Post, from the Bipolar Collaborative Network in Bethesda, Md., “Both childhood onset and treatment delay were associated with a persistently more adverse course of illness rated prospectively in adults.”

Bipolar disorder, also known as manic depression, is a mental disorder that is characterized by alternating periods of maniaBipolar disorder in children often presents differently than in adults and can be difficult to diagnose. (elevated or agitated mood) and depression. Bipolar disorder affects more than 5 million American adults according to the National Institute of Mental Health.  Although the average age of onset is 25 years, there is an increasing awareness of the disease in children. 

Post and his colleagues followed 529 adult outpatients with bipolar disorder over a period of four years.  The average age of the patients was 42. The participants were rated daily using the National Institute of Mental Health-Life Chart Method.  The study participants also completed questionnaires regarding the history of their symptoms and illness.

15 percent of the participants had symptoms before the age of 13 and 35 percent between the ages of 13-18.  During the first year of followup, compared to the patients whose symptoms developed as an adult, those with childhood onset had more manic and depressive episodes, more severe episodes of mania and depression, more days depressed, more rapid cycling, and fewer days of normal mood.

After following the participants for four years, those with onset during childhood, compared to those with adult onset, continued to have on average longer and more severe periods of depression, and fewer days of normal mood.

On average, the earlier the age at which symptoms appeared, the longer it took for the patients to be diagnosed.  In addition, the longer the delay in diagnosis, the more time patients spent depressed, the more episodes of depression they had, the worse the episodes were, and the more rapid the cycling of episodes.

Read in Full:  http://psychcentral.com/news/2010/07/28/age-of-onset-influences-prognosis-in-bipolar/16102.html


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