Early symptoms of mania and the role of parental risk

Robert L. Findling, Eric A. Youngstrom, Nora K. McNamara, Robert J. Stansbrey, Christine A. Demeter, Denise Bedoya, Shoshana Y. Kahana, Joseph R. Calabrese

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

Objectives: The objectives of this study were to: (i) describe the phenomenology of youths diagnosed with subsyndromal bipolar disorders; (ii) describe the phenomenology of youngsters who are the children of bipolar parents, who are also experiencing subsyndromal symptoms of bipolar disorder (patients with 'cyclotaxia'); and (iii) explore which symptoms may be most useful in identifying youths with cyclotaxia. Methods: Four hundred outpatients between the ages of 5 and 17 years received a diagnostic assessment and psychometric questionnaires pertaining to mood symptomatology and psychosocial functioning. Parental diagnostic information was also obtained. Children and adolescents were assigned to one of three diagnostic groups: a 'syndromal bipolar disorder (BP)' group (n = 118), a 'sub-syndromal bipolar (SUB-BP)' group (n = 75), or a 'non-bipolar (NON-BP)' group (n = 207). In addition, based on parental diagnoses, youths were assigned to either a high genetic risk group (n = 167) or a low genetic risk group (n = 233). Results: Youths with subsyndromal bipolar disorders were found to have intermediate degrees of manic symptoms than youths with bipolar disorder and youths without a bipolar diagnosis. Offspring of parents having a bipolar disorder were more likely to show symptoms of hypomania and mania than youths without a bipolar parent. Youths at genetic risk for developing a bipolar disorder were not found to be at higher risk for having a diagnosis of attention-deficit hyperactivity disorder or a disruptive behavior disorder. Finally, results suggest that elevated mood with irritability and rapid mood fluctuations are the key distinguishing characteristics of 'cyclotaxia'. Conclusions: There exists a group of youngsters who are the offspring of a parent/parents with a bipolar disorder who do not suffer from BP 1 or BP 2, yet have elevated mood symptoms and psychosocial dysfunction. As a result of these observations, treatment studies are needed for youths with 'cyclotaxia'.

Original languageEnglish (US)
Pages (from-to)623-634
Number of pages12
JournalBipolar Disorders
Volume7
Issue number6
DOIs
StatePublished - Dec 2005
Externally publishedYes

Keywords

  • Genetic risk
  • Pediatric bipolar disorder
  • Phenomenology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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