Abstract
Objective: Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms. Methods: We examined prospective outcomes during up to two years of naturalistic treatment among 3,658 adult bipolar I and II outpatients participating in a multicenter clinical effectiveness study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Age at illness onset was identified retrospectively by clinician assessment at study entry. Results: Compared to patients with onset of mood symptoms after age 18 years (n = 1,187), those with onset before age 13 years (n = 1,068) experienced earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over the two-year follow-up. Outcomes for those with onset between age 13 and 18 years (n = 1,403) were generally intermediate between these two groups. Conclusion: Consistent with previous reports in smaller cohorts, adults with retrospectively obtained early-onset bipolar disorder appear to be at greater risk for recurrence, chronicity of mood symptoms, and functional impairment during prospective observation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 391-400 |
| Number of pages | 10 |
| Journal | Bipolar Disorders |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2009 |
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Keywords
- Age of onset
- Bipolar disorder
- Chronicity
- Depression
- Maintenance
- Mania
- Recurrence
ASJC Scopus subject areas
- Psychiatry and Mental health
- Biological Psychiatry
Cite this
Retrospective age at onset of bipolar disorder and outcome during two-year follow-up : Results from the STEP-BD study. / Perlis, Roy H.; Dennehy, Ellen B.; Miklowitz, David J.; Delbello, Melissa P.; Ostacher, Michael; Calabrese, Joseph R.; Ametrano, Rebecca M.; Wisniewski, Stephen R.; Bowden, Charles L.; Thase, Michael E.; Nierenberg, Andrew A.; Sachs, Gary.
In: Bipolar Disorders, Vol. 11, No. 4, 2009, p. 391-400.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Retrospective age at onset of bipolar disorder and outcome during two-year follow-up
T2 - Results from the STEP-BD study
AU - Perlis, Roy H.
AU - Dennehy, Ellen B.
AU - Miklowitz, David J.
AU - Delbello, Melissa P.
AU - Ostacher, Michael
AU - Calabrese, Joseph R.
AU - Ametrano, Rebecca M.
AU - Wisniewski, Stephen R.
AU - Bowden, Charles L.
AU - Thase, Michael E.
AU - Nierenberg, Andrew A.
AU - Sachs, Gary
PY - 2009
Y1 - 2009
N2 - Objective: Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms. Methods: We examined prospective outcomes during up to two years of naturalistic treatment among 3,658 adult bipolar I and II outpatients participating in a multicenter clinical effectiveness study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Age at illness onset was identified retrospectively by clinician assessment at study entry. Results: Compared to patients with onset of mood symptoms after age 18 years (n = 1,187), those with onset before age 13 years (n = 1,068) experienced earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over the two-year follow-up. Outcomes for those with onset between age 13 and 18 years (n = 1,403) were generally intermediate between these two groups. Conclusion: Consistent with previous reports in smaller cohorts, adults with retrospectively obtained early-onset bipolar disorder appear to be at greater risk for recurrence, chronicity of mood symptoms, and functional impairment during prospective observation.
AB - Objective: Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms. Methods: We examined prospective outcomes during up to two years of naturalistic treatment among 3,658 adult bipolar I and II outpatients participating in a multicenter clinical effectiveness study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Age at illness onset was identified retrospectively by clinician assessment at study entry. Results: Compared to patients with onset of mood symptoms after age 18 years (n = 1,187), those with onset before age 13 years (n = 1,068) experienced earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over the two-year follow-up. Outcomes for those with onset between age 13 and 18 years (n = 1,403) were generally intermediate between these two groups. Conclusion: Consistent with previous reports in smaller cohorts, adults with retrospectively obtained early-onset bipolar disorder appear to be at greater risk for recurrence, chronicity of mood symptoms, and functional impairment during prospective observation.
KW - Age of onset
KW - Bipolar disorder
KW - Chronicity
KW - Depression
KW - Maintenance
KW - Mania
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=65549163005&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=65549163005&partnerID=8YFLogxK
U2 - 10.1111/j.1399-5618.2009.00686.x
DO - 10.1111/j.1399-5618.2009.00686.x
M3 - Article
VL - 11
SP - 391
EP - 400
JO - Bipolar Disorders
JF - Bipolar Disorders
SN - 1398-5647
IS - 4
ER -