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Further evidence for a developmental subtype of bipolar disorder defined by age at onset: results from the national epidemiologic survey on alcohol and related conditions.

Goldstein BI, Levitt AJ

Department of Psychiatry, Sunnybrook and Women's Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, Canada M4N 3M5.

OBJECTIVE: This study examines the relationship between age at onset of bipolar I disorder and illness characteristics among adults in a community sample. METHOD: The National Epidemiologic Survey on Alcohol and Related Conditions identified 1,411 adults with bipolar disorder. For analyses, bipolar disorder subjects were divided into three age at onset groups: childhood (less than 13 years old, N=113), adolescence (13-18 years old, N=339), and adulthood (19 years or older, N=959). RESULTS: Nonremitting bipolar disorder was most prevalent among childhood-onset subjects, and childhood-onset subjects were most likely to experience prolonged episodes. Antisocial personality disorder was most prevalent among childhood-onset subjects. Drug use disorders were more prevalent among childhood-onset and adolescent-onset, as compared with adult-onset, subjects. Prevalence of mixed episodes or irritability did not differ significantly between groups. CONCLUSIONS: Findings corroborate clinical studies: illness characteristics among adults with childhood-onset bipolar disorder are similar to those described in children with bipolar disorder.

Published 1 September 2006 in Am J Psychiatry, 163(9): 1633-6.
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