Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T07:33:44.941Z Has data issue: false hasContentIssue false

Neurodevelopmental antecedents of early-onset bipolar affective disorder

Published online by Cambridge University Press:  02 January 2018

Engilbert Sigurdsson*
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Eric Fombonne
Affiliation:
Institute of Psychiatry, Denmark Hill, London SE5 8AF
Kapil Sayal
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Stuart Checkley
Affiliation:
Institute of Psychiatry, Denmark Hill, London SE5 8AF
*
Engilbert Sigurdsson, The Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK. Tel: 0171 703 6333; e-mail: [email protected] and [email protected]

Abstract

Background

Developmental impairments have been identified as a risk factor for early-onset schizophrenia. Affective symptoms are more common in children and adolescents with disordered neurodevelopment than in healthy controls.

Aims

To test the hypothesis that severe early-onset mood disorders are associated with developmental antecedents.

Method

We retrospectively identified 38 adolescent cases (15 female, 23 male; mean age 14.4 years, range 11–18) who met ICD–10 Research Diagnostic Criteria for a manic episode, bipolar affective disorder or psychotic depression, and 41 controls (25 female, 16 male, mean age 14.2 years, range 11–18) with depression but without psychotic features.

Results

Cases were significantly more likely to have experienced delayed language, social or motor development (OR 5.5, 95% CI=1.4–21.6, P=0.01). in particular those who develop psychotic symptoms (OR 7.2, 95% CI=1.8–28.6, P=0.003).

Conclusions

Compared to early-onset unipolar depression, neurodevelopmental antecedents are over-represented in early-onset bipolar disorder. The validity of this finding was supported by contemporaneous IQ scores that are not subject to the same potential biases as case-note ratings.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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

Declaration of interest None.

References

Akiskal, H. S., Walker, P., Puzantian, V. R., et al (1983) Bipolar outcome in the course of depressive illness: phenomenological, familial, and pharmacologic predictors. Journal of Affective Disorders, 5, 115128.CrossRefGoogle ScholarPubMed
Biederman, J., Faraone, S. & Mick, E. (1996) Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity? Journal of the American Academy of Child and Adolescent Psychiatry, 35, 9971008.Google Scholar
Boyd, J. H. A Weissman, M. M. (1981) Epidemiology of affective disorders: a re-examination and future directions. Archives of General Psychiatry, 38, 10391046.Google Scholar
Cannon, M., Jones, P., Gilvarry, C., et al (1997) Premorbid social functioning in schizophrenia and bipolar disorder: similarities and differences. American Journal of Psychiatry, 154, 15441550.Google ScholarPubMed
Crow, T. J., Done, D. J. & Sacker, A. (1994) Neurological abnormality in children who develop psychosis in adulthood. Schizophrenia Research, 11, 96.Google Scholar
Crow, T. J., Done, D. J. & Sacker, A. (1995) Childhood precursors of psychosis as clues to its evolutionary origins. European Archives in Psychiatry and Clinical Neurosciences, 245, 6169.Google Scholar
Done, D. J., Johnstone, E. C., Frith, C. D., et al (1991) Complications of pregnancy and delivery in relation to psychosis in adult life: data from the British perinatal mortality survey sample. British Medical Journal, 302, 15761580.Google Scholar
Done, D. J., Crow, T. J., Johnstone, E. C., et al (1994a) Childhood antecedents of schizophrenia and affective illness: social adjustment at ages 7 and 11. British Medical Journal, 309, 699703.CrossRefGoogle ScholarPubMed
Done, D. J., Secker, A. & Crow, T. J. (1994b) Childhood antecedents of schizophrenia and affective illness: intellectual performance at ages 7 and II. Schizophrenia Research, 11, 9697.Google Scholar
Fombonne, E. (1998) Suicidal behaviours in vulnerable adolescents. Time trends and their correlates. British Journal of Psychiatry, 173, 154159.CrossRefGoogle ScholarPubMed
Frankenburg, W. K. & Dodds, J. B. (1967) The Denver Developmental Screening Test. Journal of Pediatrics, 71, 181191.Google Scholar
Frankenburg, W. K. & Dodds, J. B. (1969) The Denver Developmental Screening Test. Colorado: University of Colorado Medical Center.Google Scholar
Geller, B. & Luby, J. (1997) Child and adolescent bipolar disorder: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 11681176.CrossRefGoogle Scholar
Goodman, R. & Graham, R. (1994) Psychiatric problems in children with hemiplegia: cross-sectional epidemiological survey. British Medical Journal, 312, 10651069.CrossRefGoogle Scholar
Goodman, R. & Simonoff, E. (1991) Reliability of clinical ratings by trainee psychiatrists: a research note. Journal of Child Psychology and Psychiatry, 32, 551555.CrossRefGoogle ScholarPubMed
Guth, C., Jones, P. & Murray, R. (1993) Familial psychiatric illness and obstetric complications in early-onset affective disorder. A case-control study. British Journal of Psychiatry, 143, 492498.Google Scholar
Hellgren, L., Gillberg, I. C., Bagenholim, A., et al (1994) Children with deficits in attention, motor control and perception almost grown up: psychiatric and personality disorders at age 16 years. Journal of Child Psychology and Psychiatry, 35, 12551271.CrossRefGoogle ScholarPubMed
Hollis, C. (1995) Child and adolescent (juvenile onset) schizophrenia. A case control study of premorbid developmental impairments. British Journal of Psychiatry, 164, 489495.CrossRefGoogle Scholar
Jones, P., Rodgers, B., Murray, R., et al (1994) Child developmental risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet, 344, 13981402.Google Scholar
Lewinsohn, P. M., Klein, D. N. & Seeley, J. R. (1995) Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 454463.CrossRefGoogle Scholar
Lewis, S. W. & Murray, R. M. (1987) Obstetric complications, neurodevelopmental deviance, and risk of schizophrenia. Journal of Psychiatric Research, 21, 413421.Google Scholar
Lish, J. D., Dime-Meenan, S., Whybrow, P., et al (1994) The national depressive and manic-depressive association (DMDA) survey of bipolar members. Journal of Affective Disorders, 31, 281294.Google Scholar
McKenna, K., Gordon, C. T. & Rapoport, J. L. (1994) Childhood-onset schizophrenia: timely neurobiological research. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 771781.Google Scholar
Strober, M. & Carlson, G. A. (1982) Bipolar illness in adolescents with major depression. Clinical, genetic and psychopharmacologic predictors in three- to four-year prospective follow-up investigation. Archives of General Psychiatry, 39, 549555.Google Scholar
Thorley, G. (1982) The Bethlem Royal and Maudsley Hospitals clinical data register for children and adolescents. Journal of Adolescence, 5, 179189.Google Scholar
Thorley, G. (1987) Factor study of a psychiatric child rating scale. Based on ratings made by clinicians on child and adolescent clinic attenders. British Journal of Psychiatry, 150, 4959.Google Scholar
van Os, J., Jones, P., Lewis, G., et al (1997) Developmental precursors of affective illness in a general population birth cohort. Archives of General Psychiatry, 54, 625631.CrossRefGoogle Scholar
Wechsler, D. (1949) Manual for the Wechsler Intelligence Scale for Children. New York: Psychological Corporation.Google Scholar
Wechsler, D. (1974) Wechsler Intelligence Scale for Children – Revised. New York: Psychological Corporation.Google Scholar
World Health Organization (1992) Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Geneva: WHO, Division of Mental Health.Google Scholar
World Health Organization (1993) The ICD–10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.