Psychosocial functioning in a prepubertal and early adolescent bipolar disorder phenotype.
OBJECTIVE
To compare psychosocial functioning (PF) in a prepubertal and early adolescent bipolar disorder phenotype (PEA-BP) sample to two comparison groups, i.e., attention-deficit/hyperactivity disorder (ADHD) and community controls (CC).


METHODS
There were 93 PEA-BP (with or without comorbid ADHD), 81 ADHD, and 94 CC subjects who were participants in an ongoing study, the Phenomenology and Course of Pediatric Bipolar Disorders. Cases in the PEA-BP and ADHD groups were outpatients obtained by consecutive new case ascertainment, and CC subjects were from a survey conducted by the Research Triangle Institute. To fit the study phenotype, PEA-BP subjects needed to have current DSM-IV mania or hypomania with elation and/or grandiosity as one criterion. Assessments for PF were by experienced research nurses who were blind to group status. Mothers and children were separately interviewed with the Psychosocial Schedule for School Age Children-Revised.


RESULTS
Compared with both ADHD and CC subjects, PEA-BP cases had significantly greater impairment on items that assessed maternal-child warmth, maternal-child and paternal-child tension, and peer relationships.


CONCLUSIONS
Clinicians need to consider PF deficits when planning interventions. In the PEA-BP group, there was a 43% rate of hypersexuality with a <1% rate of sexual abuse, supporting hypersexuality as a manifestation of child mania.
Geller
B
B
Department of Psychiatry, Washington University School of Medicine, St. Louis 63110, USA. gellerb@medicine.wustl.edu
Bolhofner
K
K
Craney
J L
JL
Williams
M
M
DelBello
M P
MP
Gundersen
K
K
D000223:Adaptation, Psychological; D000293:Adolescent; D017668:Age of Onset; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D010287:Parent-Child Relations; D010379:Peer Group; D012917:Social Adjustment; D014481:United States / Q000453:epidemiology