Clinical Features in Childhood May Predict Psychiatric Diagnoses
the Psychiatry Advisor take:
Clinical features that appear during childhood and adolescence may help clinicians predict whether a patient will develop bipolar disorder or depression later on in life.
Ross Baldessarini, MD, director of the International Consortium for Bipolar & Psychotic Disorders Research at McLean Hospital in Belmont, Massachusetts, reviewed clinical records of patients diagnosed with either bipolar disorder or unipolar depression.
About 6.5% of the 215 patients with bipolar disorder said they had a phobia when they were a child, while none of the 199 patients with unipolar depression did. Also, hyperactivity and restlessness, and mood swings during childhood were also more common in patients with bipolar disorder than depression, the researchers reported in the Journal of Affective Disorders.
They also found generalized anxiety was more frequent among the patients with depression (15.1%) versus those with bipolar disorder (7%) during adolescence. Interestingly, depressive symptoms were more common in patients with bipolar disorder than those with depression (11.6% and 4.2%), respectively, during both childhood and adolescence.
“Having greater confidence in predicting later [bipolar disorder] should prove valuable in formulating prognosis and in organizing supportive and psychoeducational interventions aimed at limiting risk of future morbidity, disability, and self-injury or suicide as clinical circumstances may require,” the researchers commented.
Youths With Depression Engage in Co-Rumination More Than Others
Clinical features that can appear many years ahead of a psychiatric diagnosis may help doctors to predict whether patients will develop bipolar disorder or unipolar depression, say researchers.
“The need for such differential prognosis is commonly encountered clinically, particularly in young patients,” observe Ross Baldessarini (McLean Hospital, Belmont, Massachusetts) and study co-authors.
Many of the antecedents appeared during childhood. For example, in semi-structured clinical interviews, 6.5% of 215 patients with bipolar disorder recalled having phobia between the ages of 1 and 12 years, whereas none of the 119 patients with unipolar depression did so.
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