Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

Argyris Stringaris; Argelinda Baroni; Caroline Haimm; Melissa Brotman; Catherine H. Lowe; Frances Myers; Eileen Rustgi; Wanda Wheeler; Reilly Kayser; Kenneth Towbin; Ellen Leibenluft

doi:10.1016/j.jaac.2010.01.013

Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

Argyris Stringaris, Argelinda Baroni, Caroline Haimm, Melissa Brotman, Catherine H. Lowe, Frances Myers, Eileen Rustgi, Wanda Wheeler, Reilly Kayser, Kenneth Towbin, Ellen Leibenluft

Child & Adolescent Psychiatry

National Institute of Mental Health (NIH)

Research output: Contribution to journal › Article › peer-review

127 Citations (Scopus)

182 Downloads (Pure)

Abstract

Objective
An important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be significantly less likely to develop (hypo-)manic or mixed episodes over time than will youth with bipolar disorder (BD).

Method
Patients with SMD (N = 84) and narrowly defined BD (N = 93) at baseline were followed up in 6-monthly intervals using the relevant K-SADS modules to ascertain (hypo-)manic or mixed episodes.

Results
Only one of 84 SMD subjects (1/84 [1.2%]; 95% confidence interval CI = 0.0003 to 0.064) experienced a (hypo-)manic or mixed episode during the study (median follow-up = 28.7 months). The frequency of such episodes was more than 50 times higher in those with narrowly defined BD (58/93 [62.4%]; 95% CI 0.52 to 0.72).

Conclusions
These data suggest that, over an approximately 2-year follow-up period, youth with SMD are unlikely to develop (hypo-)manic or mixed episodes.

Original language	English
Pages (from-to)	397 - 405
Number of pages	9
Journal	Journal of the American Academy of Child and Adolescent Psychiatry
Volume	49
Issue number	4
DOIs	https://doi.org/10.1016/j.jaac.2010.01.013
Publication status	Published - Apr 2010

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http://europepmc.org/articles/PMC3000433

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Stringaris, A., Baroni, A., Haimm, C., Brotman, M., Lowe, C. H., Myers, F., Rustgi, E., Wheeler, W., Kayser, R., Towbin, K., & Leibenluft, E. (2010). Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up. Journal of the American Academy of Child and Adolescent Psychiatry, 49(4), 397 - 405. https://doi.org/10.1016/j.jaac.2010.01.013

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title = "Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up",

abstract = "ObjectiveAn important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be significantly less likely to develop (hypo-)manic or mixed episodes over time than will youth with bipolar disorder (BD).MethodPatients with SMD (N = 84) and narrowly defined BD (N = 93) at baseline were followed up in 6-monthly intervals using the relevant K-SADS modules to ascertain (hypo-)manic or mixed episodes.ResultsOnly one of 84 SMD subjects (1/84 [1.2%]; 95% confidence interval CI = 0.0003 to 0.064) experienced a (hypo-)manic or mixed episode during the study (median follow-up = 28.7 months). The frequency of such episodes was more than 50 times higher in those with narrowly defined BD (58/93 [62.4%]; 95% CI 0.52 to 0.72).ConclusionsThese data suggest that, over an approximately 2-year follow-up period, youth with SMD are unlikely to develop (hypo-)manic or mixed episodes.",

author = "Argyris Stringaris and Argelinda Baroni and Caroline Haimm and Melissa Brotman and Lowe, {Catherine H.} and Frances Myers and Eileen Rustgi and Wanda Wheeler and Reilly Kayser and Kenneth Towbin and Ellen Leibenluft",

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doi = "10.1016/j.jaac.2010.01.013",

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Stringaris, A, Baroni, A, Haimm, C, Brotman, M, Lowe, CH, Myers, F, Rustgi, E, Wheeler, W, Kayser, R, Towbin, K & Leibenluft, E 2010, 'Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 49, no. 4, pp. 397 - 405. https://doi.org/10.1016/j.jaac.2010.01.013

TY - JOUR

T1 - Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

AU - Stringaris, Argyris

AU - Baroni, Argelinda

AU - Haimm, Caroline

AU - Brotman, Melissa

AU - Lowe, Catherine H.

AU - Myers, Frances

AU - Rustgi, Eileen

AU - Wheeler, Wanda

AU - Kayser, Reilly

AU - Towbin, Kenneth

AU - Leibenluft, Ellen

PY - 2010/4

Y1 - 2010/4

N2 - ObjectiveAn important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be significantly less likely to develop (hypo-)manic or mixed episodes over time than will youth with bipolar disorder (BD).MethodPatients with SMD (N = 84) and narrowly defined BD (N = 93) at baseline were followed up in 6-monthly intervals using the relevant K-SADS modules to ascertain (hypo-)manic or mixed episodes.ResultsOnly one of 84 SMD subjects (1/84 [1.2%]; 95% confidence interval CI = 0.0003 to 0.064) experienced a (hypo-)manic or mixed episode during the study (median follow-up = 28.7 months). The frequency of such episodes was more than 50 times higher in those with narrowly defined BD (58/93 [62.4%]; 95% CI 0.52 to 0.72).ConclusionsThese data suggest that, over an approximately 2-year follow-up period, youth with SMD are unlikely to develop (hypo-)manic or mixed episodes.

AB - ObjectiveAn important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be significantly less likely to develop (hypo-)manic or mixed episodes over time than will youth with bipolar disorder (BD).MethodPatients with SMD (N = 84) and narrowly defined BD (N = 93) at baseline were followed up in 6-monthly intervals using the relevant K-SADS modules to ascertain (hypo-)manic or mixed episodes.ResultsOnly one of 84 SMD subjects (1/84 [1.2%]; 95% confidence interval CI = 0.0003 to 0.064) experienced a (hypo-)manic or mixed episode during the study (median follow-up = 28.7 months). The frequency of such episodes was more than 50 times higher in those with narrowly defined BD (58/93 [62.4%]; 95% CI 0.52 to 0.72).ConclusionsThese data suggest that, over an approximately 2-year follow-up period, youth with SMD are unlikely to develop (hypo-)manic or mixed episodes.

U2 - 10.1016/j.jaac.2010.01.013

DO - 10.1016/j.jaac.2010.01.013

M3 - Article

VL - 49

SP - 397

EP - 405

JO - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

IS - 4

ER -

Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

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