Adolescence bipolarity: phenotype and critical issues

Author/s Morena Tafuro, Marco Saettoni, Andrea Gragnani, Mauro Ferrara, Carlo Buonanno
Publishing Year 2016 Issue 2016/39 Language Italian
Pages 12 P. 121-132 File size 98 KB
DOI 10.3280/QPC2016-039008
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Even if Bipolar Disorder (BD) is a well established clinical picture, studies of juvenile BD are more recent. Significant controversy exists regarding the diagnostic boundaries of early-onset BD but agreement is substantial that BD and its subtreshold antecedents have a considerable impact on general functioning and quality of life. Childhood onset BD compared with adult onset BD is associated with greater risk for comorbid psychiatric disorders, substance abuse and suicide. The principal reason for the difficulties in diagnosis in children and adolescents is the developmentally different presentation of the early-onset form from the adult disorder. We know that symptoms of BD often become prominent during adolescence, but data are still limited regarding phenomenology, prevalence, course, outcome of manic-depressive illness at this age. This paper summarizes known information about vulnerability issues, neurodevelopmental and age related psychological tasks interplaying in these conditions. Additionally, we have focused the importance of integrated pharmacotherapy, psychotherapy and psychoeducation in treating adolescent onset manic states.

Keywords: Bipolar disorder, mania, adolescence, integrated treatment.

  1. Akiskal H.S., Pinto O. (1999). The evolving bipolar spectrum. The Psychiatric Clinics of North America, 22: 517-34. DOI: 10.1016/S0193-953X(05)70093-
  2. American Academy of Child and Adolescent Psychiatry (2001). Practice parameters for the assessment and treatment of children and adolescents with suicidal behaviour. J. Am. Acad. Adolesc. Psychiatry, 40: 24S-51S. DOI: 10.1097/00004583-200107001-0000
  3. APA (2013). DSM-5 – Manuale Diagnostico e Statistico dei disturbi mentali (trad. it.: Milano: Raffaello Cortina).
  4. Apter A. (2004). Costellazioni di personalita nel comportamento suicidario. Imago, 1: 55-59.
  5. Bara G.B., a cura di (2001). Manuale di Psicoterapia Cognitiva. Torino: Bollati Borighieri.
  6. Birmaher B., Axelson D., Goldstein B. et al. (2009). Four-year longitudinal course of childrenand adolescents with bipolar spectrum disorders: the Course and Outcome of Bipolar Youth (COBY) study. Am. J. Psychiatry, 166: 795-804.
  7. Blumberg H.P., Kaufman J., Martin A., Charney D.S., Krystal J.H., Peterson B.S. (2004). Significance of adolescent neurodevelopment for the neural circuitry of bipolar disorder. Ann. NY Acad. Sci., 1021: 376-83.
  8. Clemente A.S., Diniz B.S., Nicolato R., Kapczinski F.P., Soares J.C., Firmo J.O., Castro-Costa E. (2015). Bipolar disorder prevalence: a systematic review and meta-analysis of the literature. Rev. Bras. Psiquiatr., 37: 155-61. DOI: 10.1590/1516-4446-2012-169
  9. Corcos M., Bochereau D., Clervoy P., Atger F., Jeammet P. (1998). Troubles maniacodepressifs a l’adolescence. Encyclopédie Médico-Chirurgicale, 93.
  10. Ferrara M., Tafuro M., Carratelli T. (2003). Sottotipi clinici e funzionamento premorboso nella maniacalita in adolescenza. Psichiatria dell’Infanzia e dell’Adolescenza, 70, 4: 683-694.
  11. Ferrara M., Tafuro M., Carratelli T.J. (2005). I percorsi della maniacalita: il crocevia dell’adolescenza. Giornale di Neuropsichiatria dell’Età Evolutiva, 25, 2, agosto.
  12. Ferrara M., Tafuro M., Carratelli T.J. (2009). Il disturbo bipolare nella preadolescenza: familiarita e segni clinici precoci. Psichiatria dell’Infanzia e dell’Adolescenza, 76, 1 gennaio-aprile.
  13. Geller B., Tillman R., Craney J.L., Bolhofner K. (2004). Four-Year Prospective Outcome and Natural History of Mania in Children with a Prepubertal and Early Adolescent Bipolar Disorder Phenotype. Archives of General Psychiatry, 61: 459-467.
  14. Geller G., Luby J. (1997). Child and adolescent bipolar disorder: a review of the past 10 years. J. Am. Acad. Child Adolesc. Psychiatry, 36. DOI: 10.1097/000
  15. 4583-199709000-00008 Goodwin F.K., Jamison K.R. (1990). Manic Depressive Illness. New York: Oxford University Press.
  16. Goodwin G.M., Haddad P.M., Ferrier I.N., Aronson J.K., Barnes T., Cipriani A., Coghill D.R., Fazel S., Geddes J.R., Grunze H., Holmes E.A., Howes O., Hudson S., Hunt N., Jones I., Macmillan I.C., McAllister-Williams H., Miklowitz D.R., Morriss R., Munafo M., Paton C., Saharkian B.J., Saunders K., Sinclair J., Taylor D., Vieta E., Young A.H.J. (2016). Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. Psychopharmacol., 30: 495-55. DOI: 10.1177/026988111663654
  17. Goldberg J.F., Harrow M., a cura di (2000). I disturbi bipolari. Milano: Raffaello Cortina.
  18. Grimmer Y., Hohmann S., Poustka L. (2014) Is bipolar always bipolar? Understanding the controversy on bipolar disorder in children. F1000Prime Rep., 1: 6-111. DOI: 10.12703/P6-11
  19. Jamison K.R. (1994). Toccato dal fuoco. Milano: Longanesi.
  20. Jamison K.R. (1996). Una mente inquieta. Milano: Longanesi.
  21. Kovacs M., Pollock M. (1995). Bipolar disorder and Comorbid Conduct Disorder in Childhood and Adolescence. J. Am. Acad. Child Adolesc. Psychiatry, 34: 715-23. DOI: 10.1097/00004583-199506000-0001
  22. Kowatch R.A., Fristad M., Birmaher B., Wagner K.D., Findling R., Hellander M. and the child psychiatric workgroup on bipolar disorder (2005). Treatment Guidelines for Children and Adolescents with Bipolar Disorder, J. A. Acad. Child Adolesc. Psychiatry, 44: 213-35. DOI: 10.1097/00004583-200503000-0000
  23. Leverich G.S., Post R.M., Keck Jr. P.E., Altshuler L.L., Frye M.A., Kupka R.W., Nolen W.A., Suppes t., McElroy S.L., Grunze H., Denicoff K., Moravec M.K., Luckenbaugh D. (2007). The poor prognosis of childhood-onset bipolar disorder, Journal of Pediatrics, 150: 485-490.
  24. Lewinsohn P.M., Klein D.N., Saelly J.R. (1995). Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity and course. J. Am. Acad. Child Adolesc. Psychiatry, 34: 454-63. DOI: 10.1097/00004583-199504000-0001
  25. Lewinsohn P.M., Klein D.N., Seeley J.R. (2000). Bipolar Disorders during adolescence and young adulthood in a community sample. Bipolar Dis., 2: 281-293.
  26. Luby J.L., Navsaria N. (2010). Pediatric bipolar disorder: evidence for prodromal states and early markers. J. Child Psychol. Psychiatry, 51: 459-471.
  27. Mancini F., Gangemi A. (2002). Il paradosso nevrotico ovvero della resistenza al cambiamento. In: Castelfranchi C., Mancini F., Miceli M., a cura di, Fondamenti di Cognitivismo Clinico. Torino: Bollati Boringhieri.
  28. Mikita N., Stringaris A. (2013). Mood dysregulation. Eur. Child Adolesc. Psych., 22: 11-16.
  29. Najt P., Wang F., Spencer L., Johnston J.A., Cox Lippard E.T., Pittman B.P., Lacadie C., Staib L.H., Papademetris X., Blumberg H.P. (2016). Anterior Cortical Development During Adolescence in Bipolar Disorder. Biol. Psychiatry, 79: 303-10.
  30. Perlis R.H., Miyhara S., Marangell L.B., Wisniewski S.R., Ostacher M., Del Bello M.P., Bowden C.L., Sachs G.S., Nierenberg A.A. (2004). Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biological Psychiatry, 55: 875-881.
  31. Post R.M., Kowatch R.A. (2006) The health crisis of childhood-onset bipolar illness: some recommendations for its amelioration. J. Clin. Psychiatry, 67: 115-125.
  32. Post R.M., Leverich G.S., Kupka R.W., Keck P.E. Jr, McElroy S.L., Altshuler L.L., Frve M.A., Luckenbaugh D.A., Rowe M., Grunze H., Suppes T., Nolen W. (2010). Early-onset bipolar disorder and treatment delay are risk factors for poor outcome in adulthood. J. Clin. Psychiatry, 71: 864-72.
  33. Spencer T., Biederman J., Wozniak J., Faraone S., Wilnes T., Mick E. (2001). Parsing pediatric bipolar disorder from its associated comorbidity with the disruptive behavior disorders. Biol. Psychiatry, 49: 1062-70. DOI: 10.1016/S0006-3223(01)01155-
  34. Stringaris A., Baroni A., Haimm C., Britman M., Lowe C., Myers F., Rustgi E., Wheeler W., Kavser R., Towbin K., Leibenluft E. (2010). Pediatric Bipolar Disorder versus Severe Mood Dysregulation: risk for manic episodes on follow up. J. Am. Acad. Child Adolesc. Psychiatr., 49: 397-405.
  35. Weissman M.M., Bland R.C., Canini G.J., Faravelli C., Greenwald S., Hwu H.G., Joyce P.R., Karam E.G., Lee C.K., Lellouch J., Lepine J.P., Newman S.C., Rubio-Stipec M., Wells J.E., Wickrameratne P.J., Wittchen H., Yeh E.H. (1996).
  36. Cross-national epidemiology of major depression and bipolar disorder. JAMA, 276: 293-9.
  37. Whitney J., Howe M., Shoemaker V., Li S., Sanders E.M., Dijamco C., Acquaye T., Phillips J., Singh M., Chang K. (2012). Socio-emotional processing and functioning of youth at high risk for bipolar disorder. Journal of Affective Disorders, 148: 112-117.
  38. Whitney J., Joormann J., Gotlib I.H., Kelley R.G., Acquaye T., Howe M., Chang K., Singh M.K. (2012). Information processing in adolescents with bipolar I disorder. Journal of Child Psycology and Psychiatry, 53: 937-45.

Morena Tafuro, Marco Saettoni, Andrea Gragnani, Mauro Ferrara, Carlo Buonanno, Bipolarità in adolescenza: fenotipi e criticità in "QUADERNI DI PSICOTERAPIA COGNITIVA" 39/2016, pp 121-132, DOI: 10.3280/QPC2016-039008