Adolescents with bipolar I disorder whose symptoms are in remission are significantly less likely to experience conduct disorder or antisocial personality disorder, according to a study published in the Journal of Affective Disorders. By targeting symptoms of mania in youth, clinicians can diminish the risk for these disorders later on.
This study included 240 individuals with full bipolar I disorder at baseline whose data were collected from 4 independent studies. Of the baseline group, 185 (77%) completed a follow-up evaluation. Compared with individuals whose bipolar I disorder persisted, those with bipolar I disorder in remission during their adolescent years showed a much lower rate of conduct disorder and antisocial personality disorder at the 1-year follow-up (χ2=10.35; P =.001). All studies showed similar rates of conduct disorder and antisocial personality disorder at baseline, with ADHD rates of 53% among boys and 33% among girls, bipolar family at 54%, and bipolar controlled at 55% (χ2=2.60; P =.45).
The longitudinal datasets used in this study included a boys ADHD study, a girls ADHD study, a bipolar family study, and a bipolar controlled study. The average time for follow-up was 6.6±2.4 years. At baseline, the participants were 72% boys, 95% Caucasian, and were an average of 11.8±3.5 years. Among those with persistent bipolar I disorder at follow-up, 36% were on medication and attending counseling, 8% were only attending counseling, 13% were only using medication, 24% were in the hospital, and 18% were untreated.
The authors conclude that, “remission of manic symptoms at the adolescent follow up in youth with [bipolar-I] disorder were associated with a significant decrease in rates of [conduct disorder/antisocial personality disorder]. These results suggest that targeting manic symptoms in youth with [bipolar I] disorder could mitigate the course of [conduct disorder/antisocial personality disorder] in youth.”
Biederman J, Fitzgerald M, Woodworth KY, et al. Does the course of manic symptoms in pediatric bipolar disorder impact the course of conduct disorder? Findings from four prospective datasets. J Affect Disord. 2018;238:244-249.