Bipolar Disorder Often Rooted in Childhood

Toronto, ON – Psychiatry researchers at Sunnybrook have pinpointed characteristics of a specific type of bipolar disorder that commences in childhood using a community population study.

Participants with bipolar disorder were categorized into three groups based on when the illness began: childhood age at onset, adolescent age at onset, and adult age at onset. The groups were studied to find differences in the characteristics of the disease, such as number of depressions and manias throughout the course of the illness, frequency of episodes, and chronicity of symptoms, as well as differences in the proportion of participants who had drug abuse or dependence or antisocial personality disorder.

“The findings are significant as this data strongly suggests that bipolar disorder has its roots in childhood in a significant number of cases, and in such cases, the nature of the illness is particularly severe,” says Dr. Benjamin Goldstein, principal investigator of the study and psychiatrist at Sunnybrook Health Sciences Centre. “Longitudinal data will not be available for several years; in the meantime, data like this helps identify this potentially severe subgroup of people with bipolar disorder.”

The childhood onset group was more likely to remain ill longer, with fewer periods free of the illness, and to have more prolonged episodes. In addition, both the childhood onset and adolescent onset groups were more likely to have problems with drug abuse or dependence and to have personality disorders.

“This study stresses the importance of increasing awareness of the serious nature of bipolar disorder that onsets in childhood,” says Dr. Anthony Levitt, co-principal investigator of the study and chief of Psychiatry at Sunnybrook. “Work is now underway to identify these children at risk as early as possible and to develop preventive strategies to avoid the long term consequences of this illness.”

This is the first community-based population study to provide an estimate of the prevalence of childhood onset bipolar disorder. “One in 10 adults with bipolar disorder had the onset in childhood,“ reports Dr. Goldstein, who is also a Population Health Fellow in the Department of Psychiatry at University of Toronto. “Until recently, this condition has been under-recognized. We hope these results will provide support for the early identification of these children by health care professionals”.

The study is published in the September 2006 issue of the American Journal of Psychiatry.