Citation

Bolton S, Joyce DW, Gordon-Smith K, Jones L, Jones I, Geddes J, Saunders KEA. BJPsych Open 2022; 8(4).

Copyright

(Copyright © 2022, Royal College of Psychiatrists)

DOI

10.1192/bjo.2022.536

PMID

unavailable

Abstract

Background Bipolar disorder is a chronic and severe mental health disorder. Early stratification of individuals into subgroups based on age at onset (AAO) has the potential to inform diagnosis and early intervention. Yet, the psychosocial predictors associated with AAO are unknown. Aims We aim to identify psychosocial factors associated with bipolar disorder AAO.

METHOD Using data from the Bipolar Disorder Research Network UK, we employed least absolute shrinkage and selection operator regression to identify psychosocial factors associated with bipolar disorder AAO. Twenty-eight factors were entered into our model, with AAO as our outcome measure.

RESULTS We included 1022 participants with bipolar disorder (= 23.0, s.d. ± 9.86) in our model. Six variables predicted an earlier AAO: childhood abuse (β = -0.2855), regular cannabis use in the year before onset (β = -0.2765), death of a close family friend or relative in the 6 months before onset (β = -0.2435), family history of suicide (β = -0.1385), schizotypal personality traits (β = -0.1055) and irritable temperament (β = -0.0685). Five predicted a later AAO: the average number of alcohol units consumed per week in the year before onset (β = 0.1385); birth of a child in the 6 months before onset (β = 0.2755); death of parent, partner, child or sibling in the 6 months before onset (β = 0.3125); seeking work without success for 1 month or more in the 6 months before onset (β = 0.3505) and a major financial crisis in the 6 months before onset (β = 0.4575).

CONCLUSIONS The identified predictor variables have the potential to help stratify high-risk individuals into likely AAO groups, to inform treatment provision and early intervention. Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

Language: en

Keywords

adolescent; adult; human; suicide; child; aged; child abuse; bipolar disorder; United Kingdom; major clinical study; controlled study; clinical research; social psychology; financial crisis; family history; relative; onset age; temperament; friend; Article; disease marker; outcome assessment; internal validity; schizotypal personality disorder; predictive value; aetiology; sociodemographics; cannabis use; machine learning; childhood experience; psychosocial interventions; statistical methodology; Bipolar affective disorders