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P-216 - Continuity and Discontinuity of Psychopathological Characteristics of Bipolar Disorder Patient With Adult Versus Pediatric Onset

Published online by Cambridge University Press:  15 April 2020

A. Talamo
Affiliation:
Department of Psychiatry, School of Early Intervention in Psychosis, Sapienza University of Rome, Rome, Italy Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston, MA, USA
A. Antonucci
Affiliation:
Centro di Salute Mentale, RMA IV Municipio-Via Lablache
M. Pompili
Affiliation:
Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston, MA, USA Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sapienza University of Rome, Sant’andrea Hospital, Rome
P. Fiori Nastro
Affiliation:
Department of Psychiatry, School of Early Intervention in Psychosis, Sapienza University of Rome, Rome, Italy
P. Girardi
Affiliation:
Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sapienza University of Rome, Sant’andrea Hospital, Rome Department of Neuropsychiatry, Villa Rosa, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy

Abstract

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By contrast to adult bipolar disorder(A-BD), there has been considerably controversy about the existence and diagnosis of pediatric bipolar disorder(P-BD).We assessed outcome and psychopathological characteristics of A-BD vs. P-BD. We examined medical records of inpatients with DSM-IV-diagnoses of bipolar disorder. Patients were divided in two groups pediatric versus adult(>18 yrs) onset of bipolar disorder and compared for demographic and clinical data. All admitted patients were evaluated by a rating scale assessing their temperament(TEMPS-A) and DSM-IV diagnosis(MINI). Among seventy-eight patients(pediatric-BD N = 24 vs. Adult-BD N = 54; aged 34.79 ± 11.46 vs. 43.59 ± 12.75), 69% patients had an adult onset of the bipolar disorder. Pediatric-BD patients had a significant longer time of untreated full-blown psychiatric symptoms before first psychiatric contact(DUB) compared to A-BD (Mean pediatric DUB 11.04 ± 12.35 vs. adult DUB 2.23 ± 4.28,p < 0001). At onset P-BD patients had diagnosis of mood disorder in 50% cases compared to A-BD with 77.7% cases(Mood disorder diagnosis N = 12 vs. N = 42, p = .033). Regarding P-BD, most frequently polarity of onset was mixed (N = 12, 52%) versus adult-BD with depressive (N = 28, 58.3%, p = .036). Patients with P-onset showed greater psychosis lifetime compared to A-BD(1.1 vs. 0.6,p = .05). Pediatric-BD had temperament characteristics ranked hyperthimic>cyclothimic>depressive> irritable=anxious, versus adult onset hyperthimic > depressive = irritable > anxious >cyclothimic (p = 03). in our sample patients with early onset tend to maintain over time specific psychopathological characteristics compared to adult onset; this characteristics are often misdiagnosed with a variety of psychiatric diagnosis before the diagnosis of bipolar disorder and specific treatment. No differences were found for outcome measures probabily related to small sample.

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Copyright © European Psychiatric Association 2012
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