Psychosocial functioning of adolescents with and without paediatric bipolar disorder.
BACKGROUND
While there has been a growing interest in the presentation of Bipolar Disorder (BD) in children and adolescents, few studies have investigated the psychosocial functioning of these individuals and its relationship to trauma and suicidal ideation.


METHODS
63 adolescents aged 13-17 participated: 39 controls and 24 with Bipolar Disorder (BD). Group allocation and histories of trauma and suicidal ideation were obtained using the K-SADS-PL and WASH-U-KSADS. Adolescents completed questionnaires covering negative life events, self-esteem, hopelessness, regulation of anger, locus of control and coping.


RESULTS
More traumatic events and negative life experiences were reported by the BD group with over 50% of the BD sample indicating a history of trauma compared with 10% of the controls. The BD group reported lower self-esteem, more hopelessness, more negative life events, a more external locus of control and greater difficulties regulating emotion in anger-provoking situations. They were also found to have poorer coping strategies than the controls. Histories of trauma did not differentiate those with and without psychosocial problems. Further, hopelessness was found to be the best predictor of those BD adolescents reporting suicidal ideation. Comorbidity could not account for the differences found.


CONCLUSIONS
The sample was small and therefore disallowed comparisons among subtypes of BD. Cross-sectional design limited the ability to investigate causal relationships.


CONCLUSIONS
This is the first study to document the widespread psychosocial difficulties facing youth with BD, highlighting these issues as important ones to explore during assessment and treatment, particularly in management of affective storms and suicidal risk.
Department of Psychology, University of Canterbury and Youth Specialty Service, Canterbury District Health Board, Private Bag 4800, Christchurch, New Zealand. Julia.rucklidge@canterbury.ac.nz
Julia J
JJ
Rucklidge
D000223:Adaptation, Psychological; D000293:Adolescent; D000786:Anger; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D011584:Psychology; D012649:Self Concept; D020377:Self Efficacy; D012720:Severity of Illness Index; D012919:Social Behavior; D013406:Suicide, Attempted / Q000706:statistics & numerical data