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Identifying Youth at High Risk for Bipolar Disorder

Identifying Youth at High Risk for Bipolar DisorderCan teens and young adults who will later develop bipolar disorder be diagnosed and treated prior to developing full-blown symptoms?

Recent research has moved closer toward being able to identify individuals at high risk for bipolar disorder while still in their teens or early adulthood.

“These findings support the notion that people who develop a first episode of mania can be identified during the prodromal phase,” writes Dr. Andreas Bechdolf of ORYGEN Youth Health at the University of Melbourne, Australia, who led the study with his colleagues.  (A prodrome is the period of time before an illness becomes apparent, and may have some subtle signs or symptoms).

Bipolar disorder, characterized by alternating periods of depression and mania or hypomania (a milder version of mania), affects more than 20 million Americans.  Most cases typically present sometime during the 20s, although doctors are becoming more aware of children with the illness.

Bechdolf and his colleagues studied records from all 173 individuals aged 15 to 24 who had intake assessments at the public clinic ORYGEN Youth Health Program in Melbourne Australia.

The researchers developed a set of bipolar-at-risk (BAR) criteria, including items such as age, low-grade manic symptoms, family history, symptoms of depression, and symptoms of cyclothymia (a milder version of bipolar disorder with mild ups and downs).

All patients in the study were treated and followed by the clinic’s regular psychiatrists, and new and altered diagnoses were documented in the charts, including development of hypomania or mania.  The average followup length was 265.5 days.

Of the 173 participants in the study, 22 met the BAR criteria (12.7 percent).  Of the 22 that met the BAR criteria, five (22.7 percent) later went on to develop a diagnosis of bipolar disorder, as assessed by the development of mania, hypomania, or hospital admission and treatment, compared to just one patient from the non-BAR group (0.7 percent).

Bechdorf points out that while rate of development of bipolar disorder in the BAR group (22.7 percent) is more than 100 times that in the general population, “Prospective studies in bigger samples and with longer follow-up periods, better controlled antidepressant use and psychometric measures of conversions are warranted to provide further validity of these criteria.”

These data are important as recurrent bouts of depression and mania can have severe consequences for an individual’s physical and psychological health, neurocognitive function, career and educational goals, social functioning, and relationships.  Untreated, recurrent episodes of depression and mania may make the illness more difficult to treat and less responsive to medication.

“Intervening early in the course of bipolar affective disorder, in the prodromal phase, may reduce this personal and economic burden, as this strategy has the potential to delay, lessen the severity of, or even prevent full-blown disorder,” writes Bechdolf.

Dr. Bechdolf’s results can be found in the July 8 online Journal of Affective Disorders.

Source: Journal of Affective Disorders

Identifying Youth at High Risk for Bipolar Disorder

Jessica Ward Jones, MD, MPH

APA Reference
Jones, J. (2018). Identifying Youth at High Risk for Bipolar Disorder. Psych Central. Retrieved on October 1, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 20 Jul 2010)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.