title: Early risk factors for adult bipolar disorder in adolescents with mood disorders: a 15-year follow-up of a community sample.
abstract: BACKGROUND
  We aimed to outline the early risk factors for adult bipolar disorder (BPD) in adolescents with mood disorders.
  
  
  METHODS
  Adolescents (16-17 years old) with mood disorders (n = 287; 90 participants with hypomania spectrum episodes and 197 with major depressive disorder [MDD]) were identified from a community sample. Fifteen years later (at 30-33 years of age), mood episodes were assessed (n = 194). The risk of developing BPD (n = 22), compared with MDD (n = 104) or no mood episodes in adulthood (n = 68), was estimated via logistic regression. Adolescent mood symptoms, non-mood disorders, and family characteristics were assessed as potential risk factors.
  
  
  RESULTS
  Among the adolescents with mood disorders, a family history of BPD was the strongest predictor of developing BPD compared with having no mood episodes in adulthood (OR = 5.94; 95% CI = 1.11-31.73), whereas disruptive disorders significantly increased the risk of developing BPD compared with developing MDD (OR = 2.94; CI = 1.06-8.12). The risk that adolescents with MDD would develop adult BPD, versus having no mood episodes in adulthood, was elevated among those with an early disruptive disorder (OR = 3.62; CI = 1.09-12.07) or multiple somatic symptoms (OR = 6.60; CI = 1.70-25.67). Only disruptive disorders significantly predicted adult BPD among adolescents with MDD versus continued MDD in adulthood (OR = 3.59; CI = 1.17-10.97). Only a few adolescents with hypomania spectrum episodes continued to have BPD as adults, and anxiety disorders appeared to increase this risk.
  
  
  CONCLUSIONS
  Although most of the identified potential risk factors are likely general predictors of continued mood disorders, disruptive disorders emerged as specific predictors of developing adult BPD among adolescents with MDD.
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden. aivar.paaren@neuro.uu.se.
authors.forename: Aivar
authors.initials: A
authors.lastname: Päären
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden. hannesbohman@yahoo.se.
authors.forename: Hannes
authors.initials: H
authors.lastname: Bohman
authors.affiliation: Department of Neuroscience, Psychiatry, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden. lars.von_knorring@neuro.uu.se.
authors.forename: Lars
authors.initials: L
authors.lastname: von Knorring
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden. ig.olsson@neuro.uu.se.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Olsson
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden. anne-liis.von_knorring@neuro.uu.se.
authors.forename: Anne-Liis
authors.initials: AL
authors.lastname: von Knorring
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden. ulf.jonsson@neuro.uu.se.|Department of Neuroscience, Psychiatry, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden. ulf.jonsson@neuro.uu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Jonsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000523:psychology; D001714:Bipolar Disorder / Q000209:etiology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D019964:Mood Disorders / Q000523:psychology*; D012307:Risk Factors
chemical_list: D000928:Antidepressive Agents