Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study.
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.
Tijssen
Marijn J A
MJ
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, The Netherlands.
van Os
Jim
J
Wittchen
Hans-Ulrich
HU
Lieb
Roselind
R
Beesdo
Katja
K
Mengelers
Ron
R
Wichers
Marieke
M
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