Magazine article Clinical Psychiatry News

Depression More Troublesome Than Mania in Bipolar Disorder

Magazine article Clinical Psychiatry News

Depression More Troublesome Than Mania in Bipolar Disorder

Article excerpt


Among youths with bipolar spectrum disorder, depressive symptoms more adversely affected their psychological functioning and quality of life than did manic symptoms, results from a small study showed.

"We hypothesized that the impact of bipolar depression in youth would be significant, but the lopsided nature of the results was more striking than expected," researchers led by Anna R. Van Meter reported. "Across numerous measures, depression was a significant predictor of negative outcomes, mania was not.

"This is not to say that mania is not impairing, our sample included only youth with bipolar disorder, so we cannot comment on the degree to which mania and/or depression caused problems for youth with bipolar disorder, relative to youth without mood disturbance.

"Still, at the very least, these findings suggest that the collective focus on mania, often it seems at the exclusion of depression, may be misguided."

For the study, Ms. Van Meter and her associates recruited 54 youths aged 7-13 years old who met DSM-IV-TR criteria for bipolar spectrum disorders from a clinic in a large Midwestern city (J. Affect. Dis. 2013 June 12 [doi:10.1016/ j.jad.2013.05.039]).

Several categories of youth were excluded, including those who had an IQ below 70, those who were actively psychotic or had serious neurological or medical problems, and those who met the criteria for substance abuse or dependence. Youth with a primary caretaker who was in the process of experiencing an episode of depression or mania also were excluded.

The investigators used regression analyses to evaluate clinician and parent reports of manic and depressive symptoms from numerous survey instruments in an effort to determine how each set of symptoms affected child functioning.

Measures included the Washington University Schedule for Affective Disorders, the Children's Global Assessment Scale, the Young Mania Rating Scale, and the Child Bipolar Depression Rating Scale.

The mean age of the 54 study participants was 9 years, 42% were female, and more than half (60%) were of white European descent. Diagnoses included bipolar disorder not otherwise specified (57%), bipolar I disorder (41%), and bipolar II disorder (2%).

Parent-rated child depression symptoms were associated with problem behaviors (P less than .05) and lower quality of life (P less than . …

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