Abstract
Objective: A prospective study of psychiatrically well Amish children to determine differences in the frequency and pattern of clinical features that may be prodromal for bipolar 1 disorder. Method: Children with a bipolar I parent (n = 100) and children of well parents in a matched control sample (n = 110) were assessed annually for 7 years with semistructured interviews covering medical/developmental features and symptoms/behaviors that are possibly prodromal for bipolarity. Randomized histories of these 210 children were evaluated blindly by 4 clinicians for independent ratings of risk for bipolarity. Results: Thirty-eight percent of the children of bipolar parents were rated as at risk compared with 17% of children in the control sample. Most control sample children with risk ratings had well parents with a bipolar sibling (i.e., family history positive). Children with family histories negative for mental illness rarely received even a low risk rating. Clinical features significantly (p ≤ .05) more frequent among children of a bipolar parent included mood lability, low energy, anxious/worried, hyper-alert, attention problems/distractible and school role impairment, easily excited, sensitivity, somatic complaints, and stubborn/determined. Conclusion: Mini-clusters of early possible predictors suggest a natural history of episodic prodromal features rather than the chronic symptom pattern sometimes described for children at risk for bipolar disorder.
Original language | English (US) |
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Pages (from-to) | 786-796 |
Number of pages | 11 |
Journal | Journal of the American Academy of Child and Adolescent Psychiatry |
Volume | 42 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2003 |
Keywords
- Children-at-risk
- Pediatric bipolar
- Prodromal features
- Prospective study
ASJC Scopus subject areas
- Psychiatry and Mental health
- Developmental and Educational Psychology