Neurodevelopmental antecedents of early-onset bipolar affective disorder.
BACKGROUND
Developmental impairments have been identified as a risk factor for early-onset schizophrenia. Affective symptoms are more common in children and adolescents with disordered neurodevelopmental than in healthy controls.


OBJECTIVE
To test the hypothesis that severe early-onset mood disorders are associated with developmental antecedents.


METHODS
We retrospectively identified 38 adolescent cases (15 female, 23 male; mean age 14.4 years, range 11-18) who met ICD-10 Research Diagnostic Criteria for a manic episode, bipolar affective disorder or psychotic depression, and 41 controls (25 female, 16 male, mean age 14.2 years, range 11-18) with depression but without psychotic features.


RESULTS
Cases were significantly more likely to have experienced delayed language, social or motor development (OR 5.5, 95% CI = 1.4-21.6, P = 0.01), in particular those who develop psychotic symptoms (OR 7.2, 95% CI = 1.8-28.6, P = 0.003).


CONCLUSIONS
Compared to early-onset unipolar depression, neurodevelopmental antecedents are over-represented in early-onset bipolar disorder. The validity of this finding was supported by contemporaneous IQ scores that are not subject to the same potential biases as case-note ratings.
Sigurdsson
E
E
Maudsley Hospital, London, UK. E.Sigurdsson@iop.kcl.ac.uk
Fombonne
E
E
Sayal
K
K
Checkley
S
S
D000293:Adolescent; D017668:Age of Onset; D001714:Bipolar Disorder / Q000209:etiology* / Q000235:genetics / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D002658:Developmental Disabilities / Q000150:complications* / Q000235:genetics / Q000523:psychology; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D009422:Nervous System Diseases / Q000150:complications* / Q000235:genetics / Q000523:psychology; D010375:Pedigree; D012189:Retrospective Studies; D012307:Risk Factors