Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study.

Journal article

OBJECTIVE: Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms. METHODS: We examined prospective outcomes during up to two years of naturalistic treatment among 3,658 adult bipolar I and II outpatients participating in a multicenter clinical effectiveness study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Age at illness onset was identified retrospectively by clinician assessment at study entry. RESULTS: Compared to patients with onset of mood symptoms after age 18 years (n = 1,187), those with onset before age 13 years (n = 1,068) experienced earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over the two-year follow-up. Outcomes for those with onset between age 13 and 18 years (n = 1,403) were generally intermediate between these two groups. CONCLUSION: Consistent with previous reports in smaller cohorts, adults with retrospectively obtained early-onset bipolar disorder appear to be at greater risk for recurrence, chronicity of mood symptoms, and functional impairment during prospective observation.

Authors: Perlis, R; Dennehy, E; Miklowitz, D; Delbello, M; Ostacher, M

• Publication status: Published
• Journal: Bipolar disorders
• Volume: 11
• Issue: 4
• Pages: 391-400
• Publication date: 2009-06-01
• DOI: 10.1111/j.1399-5618.2009.00686.x
• EISSN: 1399-5618
• ISSN: 1398-5647
• Language: English
• Keywords: Bipolar Disorder; Adult; Longitudinal Studies; Adolescent; Quality of Life; Female; Humans; Psychiatric Status Rating Scales; Child; Age Factors; Treatment Outcome; Questionnaires; Age of Onset; Retrospective Studies; Male; Randomized Controlled Trials as Topic