Cited by 31Bipolar Disorder and TreatmentPersonality Disorders and PsychopathologySchizophrenia research and treatment

Toward prevention of bipolar disorder in at-risk children: Potential strategies ahead of the data

Open access
Post, Robert M., Goldstein, Benjamin I., Birmaher, Boris, Findling, Robert L., Frey, Benicio N., DelBello, Melissa P., Miklowitz, David J.·2020·Journal of Affective Disorders

Abstract

BACKGROUND: Despite the well-documented negative impact of untreated bipolar illness, approaches to early intervention in childhood-onset bipolar and related disorders are not well delineated. METHODS: We reviewed the extant treatment literature on children at high risk for bipolar disorder, with definitions based on family history, childhood adversity, and prodromal symptoms. RESULTS: A panoply of approaches have been described, but most interventions are based on an inadequate database to support their routine implementation. We classify early stage interventions as a function of their safety and tolerability with the hope that these might generate more rigorous study and a stronger database. LIMITATIONS: Critics may rightly argue that identifying viable treatment methods is premature given our lack of ability to reliably predict illness trajectory in very young children. However, many of the psychosocial and pharmacological interventions we present could have nonspecific positive effects across a variety of symptoms, syndromes, and diagnoses, further enhancing the rationale for more rigorous study. CONCLUSIONS: Early stage interventions have the potential to improve functioning in prodromal illness and exert long-term positive effects on the course of illness. Many of the safest interventions deserve consideration for implementation and dissemination studies.

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Crossref · 10.1016/j.jad.2020.03.025

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  • Indicated prevention in bipolar disorder was developed only fifteen years ago and is rapidly emerging, but its supporting evidence lags behind that for CHR-P.

    “Indicated prevention in bipolar disorder was developed, following the CHR-P template, only fifteen years ago 96,97 , and is rapidly emerging 98-101 . The supporting evidence lags behind that for CHR-P 99,102 .”

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2 of the 167 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Post RM, 2016b. Preventing sensitization and kindling-like progression in the recurrent affective disorders. In: Chiccetti D (Ed.), Developmental Psychopathy. John Wiley & Sons, Hoboken, NJ, pp. 971– 996.
  2. Post RM, Leverich GS, Kupka R, Keck PE Jr., McElroy SL, Altshuler LL, Frye MA, Rowe M, Grunze H, Suppes T, Nolen WA, 2015c. Increases in multiple psychiatric disorders in parents and grandparents of patients with bipolar disorder from the USA compared with The Netherlands and Germany. Psychiatr. Genet. 25, 194– 200. 26146875
  3. Ross RG, Hunter SK, Hoffman MC, McCarthy L, Chambers BM, Law AJ, Leonard S, Zerbe GO, Freedman R, 2016. Perinatal phosphatidylcholine supplementation and early childhood behavior problems: evidence for CHRNA7 moderation. Am. J. Psychiatry 173, 509– 516. 26651393 PMC5892450

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Authors
Post, R. M., Goldstein, B. I., Birmaher, B., Findling, R. L., Frey, B. N., DelBello, M. P., & Miklowitz, D. J.
Affiliations
  • George Washington University (US)
  • Sunnybrook Health Science Centre (CA)
  • University of Pittsburgh (US)
  • Virginia Commonwealth University (US)
  • St. Joseph’s Healthcare Hamilton (CA)
  • University of Cincinnati (US)
  • University of California, Los Angeles (US)
Corresponding author
Post, Robert M.
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2020-07
Volume
272
Pages
508-520
ISSN
0165-0327 (ISSN-L)
OpenAlex
W3010067892
Cited by
31
References
167
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 7 · 2021: 7 · 2020: 4
FWCI
0.87
Type
journal article
Language
en
Open access
Locations
  • Journal of Affective Disorders (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by-nc-nd)
  • eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
Funders
  • Canadian Institutes of Health Research
  • National Institute of Mental Health (R01MH123575, R34MH117200, R37MH085953)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
bipolar disorder, pediatric bipolar disorder, prevention, early intervention, vulnerable children, prodromal symptoms, family history (medicine), childhood adversity, psychosocial interventions, pharmacological interventions, safety and tolerability, illness trajectory
MeSH terms
Bipolar Disorder, Child, Child, Preschool, Humans, Prodromal Symptoms

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