Citation

Sher L. Asian J. Psychiatry 2019; 47: e101854.

Affiliation

James J. Peters Veterans' Administration Medical Center, New York, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Leo.Sher@mssm.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.ajp.2019.101854

PMID

31726423

Abstract

Individuals with childhood or adolescent onset bipolar disorder (BD) have a more difficult course and outcome than individuals with adult onsets (Faedda et al., 1995; Post et al., 2017). Studies have shown that an earlier age of onset is associated with a longer delay to first treatment of either depression or mania. Early-onset bipolar disorder (EOBD) is also associated with a significant risk of future substance use disorders and suicidal behavior (Post et al., 2017; Subramanian et al., 2017). Comorbidity of bipolar disorder and substance use disorders is lower in Asian countries in comparison to the U.S. and Europe (Subramanian et al., 2017) which may indicate a lower prevalence of EOBD in Asian countries.

EOBD is occurring when the brain is immature and developing (Post et al., 2017). A child or adolescent with EOBD has additional risks of loss of educational and social opportunities in comparison with an individual with adult onset BD.

BD is associated with a high risk of suicidal behavior (Post et al., 2017; Sher et al., 2001). The lifetime mortality due to suicide in patients with BD is estimated at approximately 20%. Many patients with BD who attempt suicide or die by suicide are individuals with EOBD (Faedda et al., 1995; Post et al., 2017). The poor outcome of EOBD may indicate that EOBD is a more severe condition than later onset BD ...

Language: en