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Child bipolar I disorder is associated with manic episodes in adulthood

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Does child bipolar I disorder continue into adulthood and what are the characteristics of subsequent episodes?


115 consecutively ascertained children (7–16 years old) with first episode DSM-IV bipolar I disorder (mixed or manic phase) of duration ⩾2 weeks, displaying elation and/or grandiosity; and Children’s Global Assessment Scale (CGAS) score ⩽60. Exclusion criteria: IQ ⩽70; major medical or neurological disorder; pervasive developmental disorder; schizophrenia; pregnant or substance use disorder at baseline; adopted.


University medical school research unit, USA; enrolment September 1995 to December 1998.

Prognostic factors:

Age, gender, illness characteristics and comorbidity (age at onset, CGAS score, psychosis, grandiose delusions, daily cycling, major depressive disorder, dysthymia, attention deficit/hyperactivity disorder, conduct disorder), referring centre (paediatric or psychiatric), parental warmth and tension/hostility (Psychosocial Schedule for School Age Children-Revised) and select mental health diagnoses in first degree relatives.


Manic episodes and substance use disorder during adulthood, recovery (8 consecutive weeks without meeting DSM-IV mania criteria), remission (2–7 weeks without meeting DSM-IV mania criteria), relapse after recovery (2 consecutive weeks of meeting DSM-IV mania criteria …

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  • Source of funding: National Institutes of Health.


  • Competing interests: GC has received research money or consultation honoraria from Bristol Myers Squibb, Otsuka, Eli Lilly, Janssen, Validus and Glaxo-Smith Kline.

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