title: Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study.
abstract: BACKGROUND
  Although (hypo)manic symptoms are common in adolescence, transition to adult bipolar disorder is infrequent.
  
  
  OBJECTIVE
  To examine whether the risk of transition to bipolar disorder is conditional on the extent of persistence of subthreshold affective phenotypes.
  
  
  METHODS
  In a 10-year prospective community cohort study of 3021 adolescents and young adults, the association between persistence of affective symptoms over 3 years and the 10-year clinical outcomes of incident DSM-IV (hypo)manic episodes and incident use of mental healthcare was assessed.
  
  
  RESULTS
  Transition to clinical outcome was associated with persistence of symptoms in a dose-dependent manner. Around 30-40% of clinical outcomes could be traced to prior persistence of affective symptoms.
  
  
  CONCLUSIONS
  In a substantial proportion of individuals, onset of clinical bipolar disorder may be seen as the poor outcome of a developmentally common and usually transitory non-clinical bipolar phenotype.
authors.affiliation: Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, The Netherlands.
authors.forename: Marijn J A
authors.initials: MJ
authors.lastname: Tijssen
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.forename: Roselind
authors.initials: R
authors.lastname: Lieb
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo
authors.forename: Ron
authors.initials: R
authors.lastname: Mengelers
authors.forename: Marieke
authors.initials: M
authors.lastname: Wichers
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D011379:Prognosis; D055815:Young Adult