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Prospective progression from high-prevalence disorders to bipolar disorder: exploring characteristics of pre-illness stages

Ratheesh, Aswin, Cotton, Susan M., Betts, Jennifer K., Chanen, Andrew, Nelson, Barnaby, Davey, Christopher G., McGorry, Patrick D., Berk, Michael and Bechdolf, Andreas 2015, Prospective progression from high-prevalence disorders to bipolar disorder: exploring characteristics of pre-illness stages, Journal of affective disorders, vol. 183, pp. 45-48, doi: 10.1016/j.jad.2015.04.025.

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Title Prospective progression from high-prevalence disorders to bipolar disorder: exploring characteristics of pre-illness stages
Author(s) Ratheesh, Aswin
Cotton, Susan M.
Betts, Jennifer K.
Chanen, Andrew
Nelson, Barnaby
Davey, Christopher G.
McGorry, Patrick D.
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Bechdolf, Andreas
Journal name Journal of affective disorders
Volume number 183
Start page 45
End page 48
Total pages 4
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-09-01
ISSN 1573-2517
Keyword(s) bipolar
depression
anxiety
substance
prospective
at-risk
Summary BACKGROUND: Identification of risk factors within precursor syndromes, such as depression, anxiety or substance use disorders (SUD), might help to pinpoint high-risk stages where preventive interventions for Bipolar Disorder (BD) could be evaluated.

METHODS: We examined baseline demographic, clinical, quality of life, and temperament measures along with risk clusters among 52 young people seeking help for depression, anxiety or SUDs without psychosis or BD. The risk clusters included Bipolar At-Risk (BAR) and the Bipolarity Index as measures of bipolarity and the Ultra-High Risk assessment for psychosis. The participants were followed up for 12 months to identify conversion to BD. Those who converted and did not convert to BD were compared using Chi-Square and Mann Whitney U tests.

RESULTS: The sample was predominantly female (85%) and a majority had prior treatment (64%). Four participants converted to BD over the 1-year follow up period. Having an alcohol use disorder at baseline (75% vs 8%, χ(2)=14.1, p<0.001) or a family history of SUD (67% vs 12.5%, χ(2)=6.0, p=0.01) were associated with development of BD. The sub-threshold mania subgroup of BAR criteria was also associated with 12-month BD outcomes. The severity of depressive symptoms and cannabis use had high effects sizes of association with BD outcomes, without statistical significance.

CONCLUSIONS AND LIMITATIONS: The small number of conversions limited the power of the study to identify associations with risk factors that have previously been reported to predict BD. However, subthreshold affective symptoms and SUDs might predict the onset of BD among help-seeking young people with high-prevalence disorders.
Language eng
DOI 10.1016/j.jad.2015.04.025
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier
Free to Read? Yes
Free to Read Start Date 2016-09-02
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073836

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.