28 Age of onset appears to impact the course of illness.29 For example, in a retrospective study of adults, patients with childhood or adolescent onset of bipolar symptoms experienced a greater number of mood episodes and were more likely to have comorbid psychiatric conditions and higher rates of rapid cycling.30 In this same study, adults with an onset of symptoms at 12 years of age or younger had the greatest

incidence of bipolar and unipolar disorders in their parents. This younger age at onset subgroup experienced a higher incidence of dysphoric Inhibitors,research,lifescience,medical mania, and a higher prevalence of a lifetime diagnosis of an anxiety disorder and drug abuse KPT-185 compared with adults who reported an age of onset of 13 years or greater.30 Additionally, the age of onset of a parent’s bipolar disorder has been found to have implications in their offspring. For example, Tsuang and Faraone31 found in adults that there was a higher risk of developing a mood disorder if a subject had relatives with an earlier age of onset of a mood disorder in http://www.selleckchem.com/products/Y-27632.html comparison with subjects whose relatives Inhibitors,research,lifescience,medical had a later age of onset. Rather than relying on retrospective studies conducted in adults, researchers have begun to examine the impact of age of onset in children and adolescents with bipolar disorder. Youths with early onset of bipolar disorder prior to the age of 12 have been found to have more firstdegree Inhibitors,research,lifescience,medical relatives

with a family history of ADHD, conduct disorder, anxiety disorders, substance dependence, suicidal behavior, and suicide attempt and completion in comparison with those subjects with a later onset of bipolar symptoms at 12 years or later.32 In addition, it has been reported that children and adolescents Inhibitors,research,lifescience,medical with childhood onset of bipolar disorder were more likely to have suffered from ADHD than those with onset during adolescence.33 Symptom course It appears

that after illness Inhibitors,research,lifescience,medical onset, children and adolescents with bipolar disorder spend the majority of time fluctuating between syndromal and subsyndromal mood episodes, with short periods of euthymia interspersed.19 For instance, Birmaher et al34 found that in 263 youths with a bipolar spectrum disorder, subjects were symptomatic Drug_discovery during approximately 60% of the 2-year follow-up period. Furthermore, DelBello et al35 found that adolescents that had been hospitalized with a BP-I diagnosis, during the year following their index inpatient stay, spent a predominant amount of their lives symptomatic. More specifically, these adolescents spent 84% of the year experiencing at least subsyndromal symptoms following their hospitalization. In addition, Geller et al21 reported that in youths experiencing mania, manic episodes lasted approximately an average of 80 weeks in duration. Similarly, in a pediatric cohort with bipolar disorder followed for 2 years, only 68% of the cohort experienced minimal or no symptoms for 8 consecutive weeks after their index episode.