Data is beginning to be reported from the COBY, or Course and Outcome of Bipolar Illness in Youth, study – the most ambitious study of childhood and adolescent onset bipolar disorders ever undertaken.

More than 500 youths were followed for up to five years.

2 million American adults live with bipolar disorders and the Child & Adolescent Bipolar Foundation estimates over 750,000 youths are affected as well. Understanding differences manifest in adults and youth is key to providing improved, more appropriate treatment.

A group of 263 children and adolescents, ages 7-17 years, were studied for two years. The National Institute of Mental Health (NIMH) sponsored research yielded interesting results. Among the findings reported in the Archives of General Psychiatry:

• the first confirmation of the phenomenon of milder bipolar subtypes converting to more severe forms (20 percent of those with bipolar II converted to bipolar I and 25% of bipolar NOS became I or II)
• symptoms were worse than in adults, and in youths with bipolar I (the most severe subtype) they lasted significantly longer than in adults
• mood swings (cycling), changes in symptoms, polarity shifts and mixed episodes were more frequent
• the earlier the onset, the more symptoms, with worse outcomes in childhood onset
• 60% had symptoms in follow-up visits
• 12% experienced psychosis and 15% made a suicide attempt or gesture
• subjects averaged 1.5 recurrences, especially depressive episodes, over two years

“For clinicians and parents, this study demonstrates the importance of systematic assessment and follow-up,” said Jeffrey Hunt, M.D., a clinical associate professor of psychiatry and human behavior and a child psychiatrist at Bradley Hospital.

More findings will be published in coming months.

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    Last reviewed: By John M. Grohol, Psy.D. on 16 Feb 2006
    Published on PsychCentral.com. All rights reserved.