Prevalence and correlates of childhood-onset bipolar disorder among adolescents
Abstract
AIM: Early-onset bipolar disorder (BD) is associated with a more severe illness as well as a number of clinical factors among adults. Early-onset can be categorized as childhood- (age < 13) or adolescent- (age ≥ 13) onset, with the two displaying different clinical profiles. We set out to examine differences in clinical, and familial characteristics among adolescents with childhood- versus adolescent-onset BD. METHODS: The study included 195 adolescents with BD, ages 14-18 years. Age of onset was determined retrospectively by self-report. Participants completed the semi-structured K-SADS-PL diagnostic interviews along with self-reported dimensional scales. Analyses examined between-group differences for clinical and familial variables. Variables associated with age of onset at p < 0.1 in univariate analyses were evaluated in a logistic regression model. RESULTS: Approximately one-fifth of participants had childhood-onset BD (n = 35; 17.9%). A number of clinical and familial factors were significantly associated with childhood-onset BD. However, there were no significant differences in depressive and manic symptom severity. In multivariate analyses, the variables most strongly associated with childhood-onset were police contact, and family history of suicidal ideation. Smoking and psychiatric hospitalization were associated with adolescent-onset. CONCLUSIONS: In this large clinical sample of adolescents with BD, one-fifth reported childhood-onset BD. Correlates of childhood-onset generally aligned with those observed in the literature. Future research is warranted to better understand the genetic and environmental implications of high familial loading of psychopathology associated with childhood-onset, and to integrate age-related treatment and prevention strategies.
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Smoking is a risk factor for an earlier age of onset of bipolar disorder.
“Smoking as a risk factor for an earlier age of onset of BD was also found in an Italian study in more than 1,000 patients of specialized outpatient clinics (41) and in a clinical sample of 195 adolescents from the US with BD (42).”
From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [42]
The Discussion (pp. 8–9) reports the opposite association in the study’s 195 adolescents with bipolar disorder: childhood-onset was negatively associated with lifetime smoking. The Multivariate analyses (p. 7) also report a significant negative association. The paper does not establish smoking as a risk factor for earlier onset. (LLM, conf=0.90)
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“Smoking as a risk factor for an earlier age of onset of BDwas also found in an Italian study inmore than 1,000 patients of specialized outpatient clinics (41) and in a clinical sample of 195 adolescents from the US with BD (42).”
Background
- Authors
- Barton, J., Mio, M., Timmins, V., Mitchell, R. H. B., & Goldstein, B. I.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Toronto (CA)
- Corresponding author
- Goldstein, Benjamin I.
- Venue
- Early Intervention in Psychiatry
- Publisher
- Wiley
- Published
- 2022-06-14
- Volume
- 17
- Issue
- 4
- Pages
- 385-393
- ISSN
- 1751-7885 (ISSN-L)
- 1751-7893
- OpenAlex
- W4282943460
- Cited by
- 6
- References
- 45
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Early Intervention in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- pediatric bipolar disorder, age of onset, family risk factors, police encounters, smoking, psychiatric hospitalization, K-SADS-PL
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Humans, Retrospective Studies, Prevalence, Suicidal Ideation
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