It may very well now be possible to diagnose and treat teenagers and young adults who will later develop bipolar disorder, prior to their developing full-blown symptoms.  Recent research has moved closer toward being able to identify those individuals at high risk for developing bipolar disorder while they are still in their teens or early adulthood.[1]

“These findings support the notion that people who develop a first episode of mania can be identified during the prodromal phase,” writes Dr. Andreas Bechdolf of ORYGEN Youth Health at the University of Melbourne, Australia, who led the study with his colleagues.  (A prodrome is the period of time before an illness becomes apparent, and may have some subtle signs or symptoms).

Most cases of bipolar disorder usually present sometime during the person's early 20s, although doctors are becoming more aware of children with the disorder.

Bechdolf and his colleagues studied records from 173 individuals aged 15 to 24 who had intake assessments at the public clinic ORYGEN Youth Health Program in Melbourne Australia.

The researchers developed a set of bipolar-at-risk (BAR) criteria, including items such as age, low-grade manic symptoms, family history, symptoms of depression, and symptoms of cyclothymia (a milder version of bipolar disorder with mild mania and depression).

All patients in the study were treated and followed by the clinic’s regular psychiatrists, and new and altered diagnoses were documented in the charts, including development of hypomania or mania.  The average follow-up length was 265.5 days.

Of the 173 participants in the study, 22 met the BAR criteria (12.7 percent).  Of the 22 that met the BAR criteria, five (22.7 percent) later went on to develop a diagnosis of bipolar disorder, as assessed by the development of mania, hypomania, or hospital admission and treatment, compared to just one patient from the non-BAR group (0.7 percent).

Bechdorf points out that while the rate of development of bipolar disorder in the BAR group (22.7 percent) is more than 100 times that in the general population, “Prospective studies in bigger samples and with longer follow-up periods, better controlled antidepressant use and psychometric measures of conversions are warranted to provide further validity of these criteria.”

 “Intervening early in the course of bipolar affective disorder, in the prodromal phase, may reduce this personal and economic burden, as this strategy has the potential to delay, lessen the severity of, or even prevent full-blown disorder,” writes Bechdolf.

Dr. Bechdolf’s results can be found in the July 8 online Journal of Affective Disorders.


[1] http://psychcentral.com/news/2010/07/20/identifying-youth-at-high-risk-for-bipolar-disorder/15805.html