The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
Pharmacological and non-drug treatment of child bipolar I disorder during prospective eight-year follow-up
Article first published online: 25 MAR 2010
© 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S
Volume 12, Issue 2, pages 164–171, March 2010
How to Cite
Geller, B., Tillman, R., Bolhofner, K. and Zimerman, B. (2010), Pharmacological and non-drug treatment of child bipolar I disorder during prospective eight-year follow-up. Bipolar Disorders, 12: 164–171. doi: 10.1111/j.1399-5618.2010.00791.x
- Issue published online: 25 MAR 2010
- Article first published online: 25 MAR 2010
- Received 10 September 2008, revised and accepted for publication 14 May 2009
- bipolar I disorder;
Geller B, Tillman R, Bolhofner K, Zimerman B. Pharmacological and non-drug treatment of child bipolar I disorder during prospective eight-year follow-up. Bipolar Disord 2010: 12: 164–171. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.
Objectives: The Phenomenology and Course of Pediatric Bipolar Disorders study, a National Institute of Mental Health-funded study of child bipolar I disorder (BP-I) begun in 1995, is a prospective follow-up study that included collecting pharmacological and non-drug treatment data.
Methods: There were 115 first-episode subjects who fit full DSM-IV criteria for BP-I, mixed or manic phase, with severity scores in the clinically impaired range, ascertained by consecutive new case ascertainment. Subjects were assessed with the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS), given separately to parents about their children and to children about themselves. All treatment was provided by the subjects’ own community practitioners, exactly as if they had not been in the research study. Thus, families were only seen for research assessments, and research staff were not at all involved in their treatment. Data on type, dose, and duration of pharmacological and non-drug treatment were collected. During follow-up, 93.9% (n = 108) were assessed at each of the nine assessment times.
Results: During the eight years, only 62.6% received any antimanic medication (antipsychotic, anticonvulsant, lithium) at any time. Percents who received non-antimanic medication included 77.4% medication for attention-deficit hyperactivity disorder and 64.3% antidepressants. A total of 67.8% of subjects were taking two or more concurrent medication classes. Subjects ascertained from psychiatric versus pediatric sites received antimanics significantly more frequently (p = 0.006). Earlier recovery during eight-year follow-up was predicted by greater percent of weeks on lithium (p = 0.017).
Conclusions: Given these findings, and the poor prognosis from prospective follow-up of this sample reported elsewhere, there is a need for further research that informs the development of effective treatment strategies.