title: Effects of comorbidity and early age of onset in young people with Bipolar Disorder on self harming behaviour and suicide attempts.
abstract: BACKGROUND
  The age of the first episode of illness in Bipolar Disorder has been shown to be an important predictor of outcome with early onset, particularly onset before puberty, associated with greater comorbidity, a poorer quality of life and greatest impairment in functioning.
  
  
  METHODS
  Baseline data from a psychotherapy study was used to examine the prevalence of other comorbid psychiatric conditions and the impact of onset at an early age on both self harming behaviour and suicide attempts in young people with Bipolar Disorder.
  
  
  RESULTS
  This study of 100 adolescents and young adults (aged 15-36 years) with Bipolar Disorder showed that comorbid conditions were very common, even at the start of their bipolar illness. Comorbidity increased as the age of onset decreased with very early onset (<13 years) patients bearing the greatest burden of disease. Greater comorbidity also significantly increased the risk of having self harmed and attempted suicide with high lethal intent. Self harming behaviour was predicted by having a lifetime diagnoses of Borderline Personality Disorder and Panic Disorder along with an early age of onset of Bipolar Disorder. In contrast, previous suicide attempts were predicted by greater comorbidity and not by very early (<13 years) age of onset.
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. stephanie.moor@otago.ac.nz
authors.forename: Stephanie
authors.initials: S
authors.lastname: Moor
authors.forename: Marie
authors.initials: M
authors.lastname: Crowe
authors.forename: Sue
authors.initials: S
authors.lastname: Luty
authors.forename: Janet
authors.initials: J
authors.lastname: Carter
authors.forename: Peter R
authors.initials: PR
authors.lastname: Joyce
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult