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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: E.Sigurdsson@iop.kcl.ac.uk and E.Sigurdsson@lishtm.ac.uk

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 

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Footnotes

Declaration of interest None.

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