Differences Between Cyclothymic Disorder and Unspecified Bipolar Disorder in Youth May Indicate Course of Disorder

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Youth with research diagnosis of cyclothymic disorder were younger, more likely to have a disruptive behavior disorder, and more likely to experience irritability.
Youth with research diagnosis of cyclothymic disorder were younger, more likely to have a disruptive behavior disorder, and more likely to experience irritability.

Youth with cyclothymic disorder show few differences from youth with medically unspecified bipolar disorder, according to a study published in the Journal of Affective Disorders. However, persistent subsyndromal mood symptoms could have implications for the severity and course of a disorder.

This study included 154 young participants, 29 of whom met criteria for a research diagnosis of cyclothymic disorder. Youth with this disorder showed a higher likelihood for disruptive behavior disorder (P =.014), irritability (P =.039), sensitivity to rejection, and mood reactivity. Youth with unspecified bipolar disorder were likelier to experience mood episodes during the follow-up period and were at higher risk of developing depression (P =.024) or hypomania (P =.016).

The average age of youth in this study was 11.96 (SD 3.3) years, with the cyclothymic disorder group being younger at baseline (P =.039). The participants were recruited from the Course and Outcome of Bipolar Youth study before being assessed for cyclothymic disorder. The follow-up period of this study was 8 years, and baseline characteristics were compared between the research diagnosis cyclothymic disorder and the unspecified bipolar disorder groups.

The study researchers conclude that “[there] were few differences between [research diagnosis of cyclothymic disorder] and [bipolar disorder - not otherwise specified] youth. However, the ways in which the groups diverged could have implications; chronic subsyndromal mood symptoms may portend a severe, but ultimately non-bipolar, course. Longer follow-up is necessary to determine the trajectory and outcomes of [cyclothymic disorder] symptoms.”

Reference

Van Meter A, Goldstein BI, Goldstein TR, et al. Parsing cyclothymic disorder and other specified bipolar spectrum disorders in youthJ Affect Disord. 2018; 238:375-382.

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