title: Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion.
abstract: BACKGROUND
  Bipolar disorder-not otherwise specified (BD-NOS) is an imprecise, heterogeneous diagnosis that is unstable in youth. This study reports rates of conversion from BD-NOS to BD-I or II in children aged 8-12, and investigates the impact of family history of bipolar disorder and depression on conversion.
  
  
  METHODS
  As part of the Multi-Family Psychoeducational Psychotherapy (MF-PEP) study, 27 children (6-12 years of age) diagnosed with BD-NOS at baseline were reassessed every 6 months over an 18-month period. Family history of bipolar disorder and depression was assessed at baseline.
  
  
  RESULTS
  One-third of the sample converted from BD-NOS to BD-I or II over 18-months. Having a first-degree relative with symptoms of bipolar disorder and having a loaded pedigree for diagnosis of depression each were associated with conversion from BD-NOS to BD-I or II (odds ratio range: 1.09-3.14; relative risk range: 1.06-2.34).
  
  
  CONCLUSIONS
  This study had very low power (range: 10-45) given the small sample size, precluding statistical significance of non-parametric Fisher's Exact test findings.
  
  
  CONCLUSIONS
  This study replicates the previous finding of a high rate of conversion from BD-NOS to BD-I or II among youth, and suggests conversion is related to symptoms of bipolar disorder or depression diagnoses in the family history. Additional research is warranted in a larger sample with a longer follow-up period.
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, OH 43210-1250, USA.
authors.forename: Molly S
authors.initials: MS
authors.lastname: Martinez
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fristad
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis* / Q000235:genetics*; D002648:Child; D003863:Depression / Q000235:genetics*; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male