More childhood onset bipolar disorder in the United States than Canada or Europe: Implications for treatment and prevention

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:74

Review

Post, Robert M.^1,2  Altshuler, Lori L.^3,4  Kupka, Ralph⁵  McElroy, Susan L.^6,7  Frye, Mark A.⁸  Rowe, Michael¹  Grunze, Heinz⁹  Suppes, Trisha^10,11  Keck, Paul E., Jr.^5,6  Leverich, Gabriele S.¹  Nolen, Willem A.¹² 

[1] Bipolar Collaborat Network, Bethesda, MD USA

[2] George Washington Univ, Dept Psychiat & Behav Sci, Washington, DC USA

[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA

[4] West Angeles Healthcare Ctr, VA Greater Angeles Healthcare Syst, Dept Psychiat, Los Angeles, CA USA

[5] Univ Cincinnati, Coll Med, Dept Psychiat & Behav Neurosci, Cincinnati, OH USA

[6] Lindner Ctr HOPE, Mason, OH USA

[7] Univ Cincinnati, Biol Psychiat Program, Coll Med, Cincinnati, OH USA

[8] Mayo Clin, Dept Psychiat, Rochester, MI USA

[9] Paracelsius Med Univ, Salzburg, Austria

[10] Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Palo Alto, CA 94304 USA

[11] VA Palo Alto Hlth Care Syst, Palo Alto, CA USA

[12] Univ Groningen, Univ Med Ctr, Groningen, Netherlands

关键词: Childhood onset bipolar disorder;    Depression;    Substance abuse;    Genetics;    Epigenetics;    Cohort effect;    Assortative mating;    Childhood adversity;    Early intervention;    Primary and secondary prevention;   

DOI  :  10.1016/j.neubiorev.2017.01.022

来源: Elsevier

【 摘 要 】

Evidence of a high or increasing incidence of childhood onset bipolar disorder in the United States (US) has been viewed skeptically. Here we review evidence that childhood onsets of bipolar disorder are more common in the US than in Europe, treatment delays are longer, and illness course is more adverse and difficult. Epidemiological data and studies of offspring at high risk also support these findings. In our cohort of outpatients with bipolar disorder, two of the major vulnerability factors for early onset - genetics and environmental adversity in childhood - were also greater in the US than in Europe. An increased familial loading for multiple psychiatric disorders was apparent in 4 generations of the family members of the patients from the US, and that familial burden was linked to early onset bipolar disorder. Since both early onset and treatment delay are risk factors for a poor outcome in adulthood, new clinical, research, and public health initiatives are needed to begin to address and ameliorate this ongoing and potentially devastating clinical situation. (C) 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.orgilicensesiby-nc-nd/4.0/).

【 授权许可】

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