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Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study

  • Marijn J. A. Tijssen (a1), Jim van Os (a2), Hans-Ulrich Wittchen (a3), Roselind Lieb (a4), Katja Beesdo (a5), Ron Mengelers (a1) and Marieke Wichers (a1)...



Although (hypo)manic symptoms are common in adolescence, transition to adult bipolar disorder is infrequent.


To examine whether the risk of transition to bipolar disorder is conditional on the extent of persistence of subthreshold affective phenotypes.


In a 10-year prospective community cohort study of 3021 adolescents and young adults, the association between persistence of affective symptoms over 3 years and the 10-year clinical outcomes of incident DSM–IV (hypo)manic episodes and incident use of mental healthcare was assessed.


Transition to clinical outcome was associated with persistence of symptoms in a dose-dependent manner. Around 30–40% of clinical outcomes could be traced to prior persistence of affective symptoms.


In a substantial proportion of individuals, onset of clinical bipolar disorder may be seen as the poor outcome of a developmentally common and usually transitory non-clinical bipolar phenotype.


Corresponding author

Marieke Wichers, Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (Vijverdal), 6200 MD Maastricht, The Netherlands. Email:


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See pp. 87–88, this issue.

This work is part of the Early Developmental Stages of Psychopathology (EDSP) Study. The EDSP-Study is funded by the German Federal Ministry of Education and Research (BMBF; project no. 01EB9405/6, 01EB 9901/6, EB01016200, 01EB0140, and 01EB0440). Part of the field work and analyses were also additionally supported by grants of the Deutsche Forschungsgemeinschaft (DFG; project no. LA1148/1-1, WI2246/1-1, WI 709/7-1, and WI 709/8-1). M.W. was supported by the Dutch Medical Council (VENI grant number 916.76.147).

Declaration of interest




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Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study

  • Marijn J. A. Tijssen (a1), Jim van Os (a2), Hans-Ulrich Wittchen (a3), Roselind Lieb (a4), Katja Beesdo (a5), Ron Mengelers (a1) and Marieke Wichers (a1)...
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