The structure of mania symptoms in a community-based samples of adults and adolescents: Associations with clinical severity, suicide attempts, comorbid disorders, and service use

Authors

• G Salem
• M Garmendia-Cedillos
• A Somenhalli
• S Qin
• L Argueta
• N Cubert
• J Krynitsky
• S Bradley
• G Dold
• D Kendricks
• Y Chudasama
• J Cushman
• D Coble
• J Dennis
• T Pohida

Abstract

There is now compelling evidence that bipolar disorder can begin in childhood and adolescence, particularly among offspring of parents with bipolar disorder. Therefore, prevention of the consequences of bipolar disorder including the development of substance use disorders, physical morbidity and suicide attempts is paramount. However, many youths with emerging symptoms of mania and depression are not detected because they fail to manifest the full clinical syndrome. Here we examine the symptom structure of mania and depression in adults and youth and their developmental specific correlates in from two large scale U.S. nationally representative sample of adults and youth over age 12.

Latent class analysis of mania symptoms yielded four classes that represented the full clinical syndrome in both adults and youth, as well as two subthreshold classes characterized by the salience of attention/ distractibility on the one hand, and behavioral symptoms with motor activity and energy changes on the other. There was remarkable similarity of profiles in youth and adults, with changes in motor activity as the most common manifestation of mania across the lifespan. Youth were much less likely to exhibit consequences of the conditions and sleep disturbances than adults. The underlying classes were better characterized by the nature of the rather than the number of the mania symptoms. These findings have important implications for identifying early manifestations of bipolar disorder in adolescents and young adults that could reduce the risk of serious lifetime consequences of this condition.

Scientific Focus Area: Epidemiology

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