Developmental differences according to age at onset in juvenile bipolar disorder

Gabriele Masi, Giulio Perugi, Stefania Millepiedi, Maria Mucci, Cristina Toni, Nicoletta Bertini, Quara Pfanner, Stefano Berloffa, Cinzia Pari

Research output: Contribution to journalArticlepeer-review


Background: This study on a large sample of unselected, consecutive children and adolescents referred to a third-level hospital who received a diagnosis of bipolar disorder (BD) was aimed at exploring whether childhood-onset BD, as compared with adolescent-onset BD, presents specific clinical features in terms of severity, functional impairment, course, prevalent mood, pattern of co-morbidity, and treatment outcome. Methods: A total of 136 patients, 81 males (59.6%) and 55 females (40.4%), mean age 13.5 ± 2.9 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of BD according to a structured clinical interview Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), were included in the study. Results: Eighty patients (58.8%) had a childhood-onset BD (before 12 years of age) and 56 (41.2%) had an adolescents-onset BD. Compared with the adolescent-onset BD, patients with childhood-onset were more frequently males and had a more frequent co-morbidity with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). An episodic course was found in only 42.5% of bipolar children, but 76.8% of youngsters with adolescent-onset BD. Severity, 6-month treatment outcome, prevalent mood (elated versus irritable), and co-morbid anxiety did not differentiate the two groups. Conclusions: Our findings suggest that a very early age at onset may identify a form of BD with a more frequent subcontinuous course and a heavy co-morbidity with ADHD.

Original languageEnglish
Pages (from-to)679-685
Number of pages7
JournalJournal of Child and Adolescent Psychopharmacology
Issue number6
Publication statusPublished - Dec 2006

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health
  • Pharmacology, Toxicology and Pharmaceutics(all)


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