Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-28T10:38:07.786Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations

Published online by Cambridge University Press:  07 July 2008

David J. Miklowitz  and
Kiki D. Chang
David J. Miklowitz*
Affiliation:
University of Colorado, Boulder
Kiki D. Chang
Affiliation:
Stanford University School of Medicine
*
Address correspondence and reprint requests to: David J. Miklowitz, Department of Psychology, University of Colorado at Boulder, 345 UCB, Boulder, CO 80309; E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

This article examines how bipolar symptoms emerge during development, and the potential role of psychosocial and pharmacological interventions in the prevention of the onset of the disorder. Early signs of bipolarity can be observed among children of bipolar parents and often take the form of subsyndromal presentations (e.g., mood lability, episodic elation or irritability, depression, inattention, and psychosocial impairment). However, many of these early presentations are diagnostically nonspecific. The few studies that have followed at-risk youth into adulthood find developmental discontinuities from childhood to adulthood. Biological markers (e.g., amygdalar volume) may ultimately increase our accuracy in identifying children who later develop bipolar I disorder, but few such markers have been identified. Stress, in the form of childhood adversity or highly conflictual families, is not a diagnostically specific causal agent but does place genetically and biologically vulnerable individuals at risk for a more pernicious course of illness. A preventative family-focused treatment for children with (a) at least one first-degree relative with bipolar disorder and (b) subsyndromal signs of bipolar disorder is described. This model attempts to address the multiple interactions of psychosocial and biological risk factors in the onset and course of bipolar disorder.

Type
Research Article
Information
Development and Psychopathology , Volume 20 , Issue 3 , Summer 2008 , pp. 881 - 897
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Preparation of this manuscript was supported by Grants MH62555, MH073871, and MH077856 (to D.J.M.), a Faculty Fellowship from the University of Colorado, a Distinguished Investigator Award from the National Alliance for Research on Schizophrenia and Depression (to D.J.M.), and an NIMH K-Award (to K.D.C.).

References

Akiskal, H. S. (1995). Developmental pathways to bipolarity: Are juvenile-onset depressions pre-bipolar? Journal of the American Academy of Child & Adolescent Psychiatry, 34, 754–763.CrossRefGoogle ScholarPubMed
Alda, M. (1997). Bipolar disorder: From families to genes. Canadian Journal of Psychiatry, 42, 378–387.Google Scholar
Altshuler, L. L., Post, R. M., Leverich, G. S., Mikalauskas, K., Rosoff, A., & Ackerman, L. (1995). Antidepressant-induced mania and cycle acceleration: A controversy revisited. American Journal of Psychiatry, 152, 1130–1138.Google ScholarPubMed
Biederman, J., Mick, E., Faraone, S. V., Spencer, T., Wilens, T. E., & Wozniak, J. (2003). Current concepts in the validity, diagnosis and treatment of paediatric bipolar disorder. International Journal of Neuropsychopharmacology, 6, 293–300.Google Scholar
Birmaher, B., Axelson, D., Strober, M., Gill, M. K., Valeri, S., Chiappetta, L., et al. (2006). Clinical course of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry, 63, 175–183.CrossRefGoogle ScholarPubMed
Blumberg, H. P., Kaufman, J., Martin, A., Charney, D. S., Krystal, J. H., & Peterson, B. S. (2004). Significance of adolescent neurodevelopment for the neural circuitry of bipolar disorder. Annals of the New York Academy of Sciences, 1021, 376–383.Google Scholar
Caetano, S. C., Olvera, R. L., Glahn, D., Fonseca, M., Pliszka, S., & Soares, J. C. (2005). Fronto-limbic brain abnormalities in juvenile onset bipolar disorder. Biological Psychiatry, 58, 525–531.CrossRefGoogle ScholarPubMed
Carlson, G. A., Jensen, P. S., Findling, R. L., Meyer, R. E., Calabrese, J., DelBello, M. P., et al. (2003). Methodological issues and controversies in clinical trials with child and adolescent patients with bipolar disorder: Report of a consensus conference. Journal of Child and Adolescent Psychopharmacology, 13, 13–27.CrossRefGoogle ScholarPubMed
Carlson, G. A., & Weintraub, S. (1993). Childhood behavior problems and bipolar disorder—Relationship or coincidence? Journal of Affective Disorders, 28, 143–153.CrossRefGoogle ScholarPubMed
Caspi, A., Moffitt, T. E., Morgan, J., Rutter, M., Taylor, A., Arseneault, L., et al. (2004). Maternal expressed emotion predicts children's antisocial behavior problems: Using monozygotic-twin differences to identify environmental effects on behavioral development. Development and Psychopathology, 40, 149–161.Google ScholarPubMed
Chang, K., Adleman, N. E., Dienes, K., Simeonova, D. J., Menon, V., & Reiss, A. (2004). Anomalous prefrontal–subcortical activation in familial pediatric bipolar disorder: A functional magnetic resonance imaging investigation. Archives of General Psychiatry, 61, 781–792.Google Scholar
Chang, K., Howe, M., Gallelli, K., & Miklowitz, D. (2006). Prevention of pediatric bipolar disorder: Integration of neurobiological and psychosocial processes. Annals of the New York Academy of Sciences, 1094, 235–247.CrossRefGoogle ScholarPubMed
Chang, K., Steiner, H., & Ketter, T. (2003). Studies of offspring of parents with bipolar disorder. American Journal of Medical Genetics C: Seminars in Medical Genetics, 123, 26–35.CrossRefGoogle Scholar
Chang, K. D., Dienes, K., Blasey, C., Adleman, N., Ketter, T., & Steiner, H. (2003). Divalproex monotherapy in the treatment of bipolar offspring with mood and behavioral disorders and at least mild affective symptoms. Journal of Clinical Psychiatry, 64, 936–942.CrossRefGoogle ScholarPubMed
Chang, K. D., Steiner, H., & Ketter, T. A. (2000). Psychiatric phenomenology of child and adolescent bipolar offspring. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 453–460.CrossRefGoogle ScholarPubMed
Cicchetti, D., & Rogosch, F. A. (1999). Psychopathology as risk for adolescent substance use disorders: A developmental psychopathology perspective. Journal of Clinical Child Psychology, 28, 355–365.CrossRefGoogle ScholarPubMed
Cicchetti, D., & Toth, S. L. (1998). The development of depression in children and adolescents. American Psychologist, 53, 221–241.CrossRefGoogle ScholarPubMed
Correll, C. U., Penzner, J. B., Frederickson, A. M., Richter, J. J., Auther, A. M., Smith, C. W., et al. (2007). Differentiation in the preonset phases of schizophrenia and mood disorders: Evidence in support of a bipolar mania prodrome. Schizophrenia Bulletin, 33, 703–713.CrossRefGoogle ScholarPubMed
Correll, C. U., Penzner, J. B., Kafantaris, V., Nakayama, E., Auther, A., Lencz, T., et al. (2006). A lengthy and symptomatic prodrome precedes the first manic episode in early-onset bipolar disorder. Paper presented at the NIMH Pediatric Bipolar Disorders Conference, Chicago, March 30, 2006.Google Scholar
Coryell, W., Scheftner, W., Keller, M., Endicott, J., Maser, J., & Klerman, G. L. (1993). The enduring psychosocial consequences of mania and depression. American Journal of Psychiatry, 150, 720–727.Google ScholarPubMed
Coville, A. L., Miklowitz, D. J., Taylor, D. O., & Low, K. (2008). Correlates of high expressed emotion attitudes among parents of bipolar adolescents. Journal of Clinical Psychology, 64, 438–449.CrossRefGoogle ScholarPubMed
DelBello, M. P. (2006). The neurophysiology of childhood and adolescent bipolar disorder. CNS Spectrums, 11, 298–311.CrossRefGoogle ScholarPubMed
DelBello, M. P., Adler, C. M., Whitsel, R. M., Stanford, K. E., & Strakowski, S. M. (2007). A 12-week single-blind trial of quetiapine for the treatment of mood symptoms in adolescents at high risk for developing bipolar I disorder. Journal of Clinical Psychiatry, 68, 789–795.CrossRefGoogle ScholarPubMed
Dienes, K. A., Hammen, C., Henry, R. M., Cohen, A. N., & Daley, S. E. (2006). The stress sensitization hypothesis: Understanding the course of bipolar disorder. Journal of Affective Disorders, 95, 43–49.Google Scholar
Egeland, J. A., Blumenthal, R. L., Nee, J., Sharpe, L., & Endicott, J. (1987). Reliability and relationship of various ages of onset criteria for major affective disorder. Journal of Affective Disorders, 12, 159–165.CrossRefGoogle ScholarPubMed
Egeland, J. A., Hostetter, A. M., Pauls, D. L., & Sussex, J. N. (2000). Prodromal symptoms before onset of manic-depressive disorder suggested by first hospital admission histories. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1245–1252.CrossRefGoogle ScholarPubMed
Egeland, J. A., Shaw, J. A., Endicott, J., Pauls, D. L., Allen, C. R., Hostetter, A. M., et al. (2003). Prospective study of prodromal features for bipolarity in well Amish children. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 786–796.Google Scholar
Emiroglu, N., Ozerdem, A., Miklowitz, D. J., Baykara, A., & Akay, A. (in press). Mood and disruptive behavior disorders and symptoms in the offspring of patients with bipolar I disorder. Journal of World Psychiatry.Google Scholar
Faraone, S. V., Biederman, J., Mennin, D., Wozniak, J., & Spencer, T. (1997). Attention-deficit hyperactivity disorder with bipolar disorder: A familial subtype? Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1378–1387.Google Scholar
Fergus, E. L., Miller, R. B., Luckenbaugh, D. A., Leverich, G. S., Findling, R. L., Speer, A. M., et al. (2003). Is there progression from irritability/dyscontrol to major depressive and manic symptoms? A retrospective community survey of parents of bipolar children. Journal of Affective Disorders, 77, 71–78.CrossRefGoogle ScholarPubMed
Findling, R. L., Frazier, T. W., Youngstrom, E. A., McNamara, N. K., Stansbrey, R. J., Gracious, B. L., et al. (2005). Double-blind, placebo-controlled trial of divalproex monotherapy in the treatment of symptomatic youth at high risk for developing bipolar disorder. Journal of Clinical Psychiatry, 68, 781–788.Google Scholar
Findling, R. L., Youngstrom, E. A., McNamara, N. K., Stansbrey, R. J., Demeter, C. A., Bedoya, D., et al. (2005). Early symptoms of mania and the role of parental risk. Bipolar Disorders, 7, 623–634.CrossRefGoogle ScholarPubMed
Gallelli, K. A., Wagner, C. M., Karchemskiy, A., Howe, M., Spielman, D., Reiss, A., et al. (2005). N-Acetylaspartate levels in bipolar offspring with and at high-risk for bipolar disorder. Bipolar Disorders, 7, 589–597.CrossRefGoogle ScholarPubMed
Garber, J. (2006). Depression in children and adolescents: Linking risk research and prevention. American Journal of Preventive Medicine, 31, S104–S125.Google Scholar
Geller, B., Tillman, R., Craney, J. L., & Bolhofner, K. (2004). Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. Archives of General Psychiatry, 61, 459–467.Google Scholar
Geller, B., Warner, K., Williams, M., & Zimerman, B. (1998). Prepubertal and young adolescent bipolarity versus ADHD: Assessment and validity using the WASH-U-KSADS, CBCL and TRF. Journal of Affective Disorders, 51, 93–100.CrossRefGoogle Scholar
Geller, B., Zimerman, B., Williams, M., Bolhofner, K., & Craney, J. L. (2001). Bipolar disorder at prospective follow-up of adults who had prepubertal major depressive disorder. American Journal of Psychiatry, 158, 125–127.Google Scholar
Hammen, C., & Gitlin, M. (1997). Stress reactivity in bipolar patients and its relation to prior history of disorder. American Journal of Psychiatry, 154, 856–857.Google ScholarPubMed
Hashimoto, K., Shimizu, E., & Iyo, M. (2004). Critical role of brain-derived neurotrophic factor in mood disorders. Brain Research Review, 45, 104–114.Google Scholar
Hasler, G., Drevets, W. C., Gould, T. D., Gottesman, I. I., & Manji, H. K. (2006). Toward constructing an endophenotype strategy for bipolar disorders. Biological Psychiatry, 60, 93–105.Google Scholar
Hillegers, M. H., Reichart, C. G., Wals, M., Verhulst, F. C., Ormel, J., & Nolen, W. A. (2005). Five-year prospective outcome of psychopathology in the adolescent offspring of bipolar parents. Bipolar Disorders, 7, 344–350.Google Scholar
Isometsa, E. T. (1993). Course, outcome, and suicide risk in bipolar disorder: A review. Psychiatric Fennica, 24, 113–124.Google Scholar
Karchemskiy, A., Garrett, A., Howe, M., Adleman, N., Simeonova, D., Reiss, A., et al. (2008). Decreased amygdalar volume in familial subsyndromal bipolar disorder. Manuscript submitted for publication.Google Scholar
Kendler, K. (2005). “A gene for … ”: The nature of gene action in psychiatric disorders. American Journal of Psychiatry, 162, 1243–1252.CrossRefGoogle ScholarPubMed
Kim, E. Y., & Miklowitz, D. J. (2002). Childhood mania, attention deficit hyperactivity disorder and conduct disorder: A critical review of diagnostic dilemmas. Bipolar Disorders, 4, 215–225.Google Scholar
Kochman, F. J., Hantouche, E. G., Ferrari, P., Lancrenon, S., Bayart, D., & Akiskal, H. S. (2005). Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder. Journal of Affective Disorders, 85, 181–189.Google Scholar
LaPalme, M., Hodgins, S., & LaRoche, C. (1997). Children of parents with bipolar disorder: A meta-analysis of risk for mental disorders. Canadian Journal of Psychiatry, 42, 623–631.Google Scholar
Leibenluft, E., Cohen, P., Gorrindo, T., Brook, J. S., & Pine, D. S. (2006). Chronic vs. episodic irritability in youth: A community-based, longitudinal study of clinical and diagnostic associations. Journal of Child and Adolescent Psychopharmacology, 16, 456–466.Google Scholar
Leverich, G. S., McElroy, S. L., Suppes, T., Keck, P. E. J., Denicoff, K. D., Nolen, W. A., et al. (2002). Early physical and sexual abuse associated with an adverse course of bipolar illness. Biological Psychiatry, 51, 288–297.Google Scholar
Leverich, G. S., Post, R. M., Keck, P. E. J., Altshuler, L. L., Frye, M. A., Kupka, R. W., et al. (2007). The poor prognosis of childhood-onset bipolar disorder. Journal of Pediatrics, 150, 485–490.Google Scholar
Lewinsohn, P. M., Klein, D. N., & Seeley, J. R. (2000). Bipolar disorder during adolescence and young adulthood in a community sample. Bipolar Disorders, 2, 281–293.Google Scholar
Lewinsohn, P. M., Seeley, J. R., & Klein, D. N. (2003). Bipolar disorders during adolescence. Acta Psychiatrica Scandinavaca, 418 (Suppl.), 47–50.CrossRefGoogle Scholar
Lish, J. D., Dime-Meenan, S., Whybrow, P. C., Price, R. A., & Hirschfeld, R. M. (1994). The National Depressive and Manic-Depressive Association (NDMDA) survey of bipolar members. Journal of Affective Disorders, 31, 281–294.CrossRefGoogle Scholar
Manji, H. K., & Duman, R. S. (2001). Impairments of neuroplasticity and cellular resilience in severe mood disorders: Implications for the development of novel therapeutics. Psychopharmacology Bulletin, 35, 5–49.Google ScholarPubMed
Masi, G., Perugi, G., Toni, C., Millepiedi, S., Mucci, M., Bertini, N., et al. (2004). Obsessive–compulsive bipolar comorbidity: Focus on children and adolescents. Journal of Affective Disorders, 78, 175–183.CrossRefGoogle ScholarPubMed
Mathews, C. A., & Reus, V. I. (2003). Genetic linkage in bipolar disorder. CNS Spectrums, 8, 891–904.Google Scholar
McGlashan, T. H., Zipursky, R. B., Perkins, D., Addington, J., Miller, T., Woods, S. W., et al. (2006). Randomized, double-blind trial of olanzapine versus placebo in patients prodromally symptomatic for psychosis. American Journal of Psychiatry, 163, 790–799.CrossRefGoogle ScholarPubMed
Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., et al. (2007). Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of General Psychiatry, 64, 543–552.Google Scholar
Miklowitz, D. J., Biuckians, A., & Richards, J. A. (2006). Early-onset bipolar disorder: A family treatment perspective. Development and Psychopathology, 18, 1247–1265.Google Scholar
Miklowitz, D. J., & George, E. L. (2008). The bipolar teen: What you can do to help your teen and your family New York: Guilford Press.Google Scholar
Miklowitz, D. J., George, E. L., Richards, J. A., Simoneau, T. L., & Suddath, R. L. (2003). A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Archives of General Psychiatry, 60, 904–912.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., Snyder, K. S., & Mintz, J. (1988). Family factors and the course of bipolar affective disorder. Archives of General Psychiatry, 45, 225–231.Google Scholar
Miklowitz, D. J., Otto, M. W., Frank, E., Reilly-Harrington, N. A., Kogan, J. N., Sachs, G. S., et al. (2007). Intensive psychosocial intervention enhances functioning in patients with bipolar depression: Results from a 9-month randomized controlled trial. American Journal of Psychiatry, 164, 1–8.Google Scholar
Miklowitz, D. J., Otto, M. W., Frank, E., Reilly-Harrington, N. A., Wisniewski, S. R., Kogan, J. N., et al. (2007). Psychosocial treatments for bipolar depression: A 1-year randomized trial from the Systematic Treatment Enhancement Program. Archives of General Psychiatry, 64, 419–427.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Simoneau, T. L., George, E. L., Richards, J. A., Kalbag, A., Sachs-Ericsson, N., et al. (2000). Family-focused treatment of bipolar disorder: One-year effects of a psychoeducational program in conjunction with pharmacotherapy. Biological Psychiatry, 48, 582–592.CrossRefGoogle Scholar
Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. B., & Olfson, M. (2007). National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Archives of General Psychiatry, 64, 1032–1039.Google Scholar
Murray, L., Kempton, C., Woolgar, M., & Hooper, R. (1993). Depressed mothers' speech to their infants and its relation to infant gender and cognitive development. Journal of Child Psychology and Psychiatry, 34, 1083–1101.CrossRefGoogle ScholarPubMed
NIMH. (2001). Research roundtable on prepubertal bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 871–878.Google Scholar
O'Connell, R. A., Mayo, J. A., Flatow, L., Cuthbertson, B., & O'Brien, B. E. (1991). Outcome of bipolar disorder on long-term treatment with lithium. British Journal of Psychiatry, 159, 132–129.Google Scholar
Pavuluri, M. N., Birmaher, B., & Naylor, M. W. (2005). Pediatric bipolar disorder: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 846–871.CrossRefGoogle ScholarPubMed
Pavuluri, M. N., Graczyk, P. A., Henry, D. B., Carbray, J. A., Heidenreich, J., & Miklowitz, D. J. (2004). Child and family-focused cognitive behavioral therapy for pediatric bipolar disorder: Development and preliminary results. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 528–537.Google Scholar
Perlis, R. H., Miyahara, S., Marangell, L. B., Wisniewski, S. R., Ostacher, M., DelBello, M. P., et al. (2004). Long-term implications of early onset in bipolar disorder: Data from the first 1000 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Biological Psychiatry, 55, 875–881.CrossRefGoogle ScholarPubMed
Phillips, M. L., Drevets, W. C., Rauch, S. L., & Lane, R. (2003). Neurobiology of emotion perception II: Implications for major psychiatric disorders. Biological Psychiatry, 54, 515–528.CrossRefGoogle ScholarPubMed
Post, R. M. (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry, 149, 999–1010.Google Scholar
Post, R. M. (2002). Do the epilepsies, pain syndromes, and affective disorders share common kindling-like mechanisms? Epilepsy Research, 50, 203–219.Google Scholar
Post, R. M., & Leverich, G. S. (2006). The role of psychosocial stress in the onset and progression of bipolar disorder and its comorbidities: The need for earlier and alternative modes of therapeutic intervention. Development and Psychopathology, 18, 1181–1211.Google Scholar
Rajkowska, G. (2000). Postmortem studies in mood disorders indicate altered numbers of neurons and glial cells. Biological Psychiatry, 48, 766–777.Google Scholar
Rajkowska, G., Halaris, A., & Selemon, L. D. (2001). Reductions in neuronal and glial density characterize the dorsolateral prefrontal cortex in bipolar disorder. Biological Psychiatry, 49, 741–752.Google Scholar
Rea, M. M., Tompson, M., Miklowitz, D. J., Goldstein, M. J., Hwang, S., & Mintz, J. (2003). Family focused treatment vs. individual treatment for bipolar disorder: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 71, 482–492.Google Scholar
Reichart, C. G., & Nolen, W. A. (2004). Earlier onset of bipolar disorder in children by antidepressants or stimulants? An hypothesis. Journal of Affective Disorders, 78, 81–84.CrossRefGoogle ScholarPubMed
Rich, B. A., Vinton, D. T., Roberson-Nay, R., Hommer, R. E., Berghorst, L. H., McClure, E. B., et al. (2006). Limbic hyperactivation during processing of neutral facial expressions in children with bipolar disorder. Proceedings of the National Academy of Sciences of the United States of America, 103, 8900–8905.CrossRefGoogle ScholarPubMed
Shaw, J. A., Egeland, J. A., Endicott, J., Allen, C. R., & Hostetter, A. M. (2005). A 10-year prospective study of prodromal patterns for bipolar disorder among Amish youth. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 1104–1011.Google Scholar
Simoneau, T. L., Miklowitz, D. J., Richards, J. A., Saleem, R., & George, E. L. (1999). Bipolar disorder and family communication: Effects of a psychoeducational treatment program. Journal of Abnormal Psychology, 108, 588–597.Google Scholar
Singh, M. K., DelBello, M. P., Kowatch, R. A., & Strakowski, S. M. (2006). Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children. Bipolar Disorders, 8, 710–720.Google Scholar
Smoller, J. W., & Finn, C. T. (2003). Family, twin, and adoption studies of bipolar disorder. American Journal of Medical Genetics, Part C: Seminars in Medical Genetics, 123, 48–58.CrossRefGoogle Scholar
Snyder, D. K., Castellani, A. M., & Whisman, M. A. (2006). Current status and future directions in couple therapy. Annual Review of Psychology, 57, 1–28.Google Scholar
Strakowski, S. M., Delbello, M. P., & Adler, C. M. (2005). The functional neuroanatomy of bipolar disorder: A review of neuroimaging findings. Molecular Psychiatry, 10, 105–116.CrossRefGoogle ScholarPubMed
Strakowski, S. M., DelBello, M. P., Zimmerman, M. E., Getz, G. E., Mills, N. P., Ret, J., et al. (2002). Ventricular and periventricular structural volumes in first- versus multiple-episode bipolar disorder. American Journal of Psychiatry, 159, 1841–1847.Google Scholar
Suppes, T., Leverich, G. S., Keck, P. E., Nolen, W. A., Denicoff, K. D., Altshuler, L. L., et al. (2001). The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. Journal of Affective Disorders, 67, 45–59.CrossRefGoogle ScholarPubMed
Tillman, R., & Geller, B. (2006). Controlled study of switching from attention-deficit/hyperactivity disorder to a prepubertal and early adolescent bipolar I disorder phenotype during 6-year prospective follow-up: Rate, risk, and predictors. Development and Psychopathology, 18, 1037–1053.Google Scholar
Tillman, R., Geller, B., Craney, J. L., Bolhofner, K., Williams, M., & Zimerman, B. (2004). Relationship of parent and child informants to prevalence of mania symptoms in children with a prepubertal and early adolescent bipolar disorder phenotype. American Journal of Psychiatry, 161, 1278–1284.Google Scholar
Tillman, R., Geller, B., Nickelsburg, M. J., Bolhofner, K., Craney, J. L., DelBello, M. P., et al. (2003). Life events in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. Journal of Child and Adolescent Psychopharmacology, 13, 243–251.CrossRefGoogle Scholar
Verhulst, F. C., van der Ende, J., Ferdinand, R. F., & Kasius, M. C. (1997). The prevalence of DSM-III-R diagnoses in a national sample of Dutch adolescents. Archives of General Psychiatry, 54, 329–336.Google Scholar
Vittengl, J. R., Clark, L. A., Dunn, T. W., & Jarrett, R. B. (2007). Reducing relapse and recurrence in unipolar depression: A comparative meta-analysis of cognitive–behavioral therapy's effects. Journal of Consulting and Clinical Psychology, 75, 475–488.Google Scholar
Wals, M., Hillegers, M. H. J., Reichart, C. G., Verhulst, F. C., Nolen, W. A., & Ormel, J. (2005). Stressful life events and onset of mood disorders in children of bipolar parents during 14-month follow-up. Journal of Affective Disorders, 87, 253–263.Google Scholar
Yan, L. J., Hammen, C., Cohen, A. N., Daley, S. E., & Henry, R. M. (2004). Expressed emotion versus relationship quality variables in the prediction of recurrence in bipolar patients. Journal of Affective Disorders, 83, 199–206.Google Scholar
Yurgelun-Todd, D. A., Gruber, S. A., Kanayama, G., Killgore, W. D., Baird, A. A., & Young, A. D. (2000). fMRI during affect discrimination in bipolar affective disorder. Bipolar Disorders, 2(3, Part 2), 237–248.CrossRefGoogle ScholarPubMed