Defining and validating bipolar disorder in the preschool period

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Frequency of BD in all inpatients, age of symptom onset, phenomenology of mood episodes, lifetime psychiatric comorbidity, differences between very-early-onset (=0.03).

Anxiety disorders, substance abuse, specific learning disabilities, and attention deficit hyperactivity disorder were the most frequent lifetime comorbid conditions.

For a long time, BD was rarely diagnosed in pediatric populations.

However, studies have shown that approximately 30%–60% of individuals diagnosed with BD as adults retrospectively report an onset of illness prior to 20 years of age.

Two-sample Welch’s were used to compare mean ages between sexes, age-of-onset groups, and BD- and non-BD-offspring groups (the Shapiro–Wilk test was used to test normality assumptions).

Associations between sex and categorical variables, as well as between age of onset and categorical variables, were investigated using Fisher’s exact test.

Conduct disorders, multigenerational family history of BD, subthreshold BD symptoms, and baseline deficits in emotional regulation have been identified.

Studying the initial stages of BD may therefore improve clinical practices regarding early detection of the illness and avoidance of diagnostic omissions or iatrogenic harm.

Over the past decade, considerable progress has been made in clinical studies of the onset and development of pediatric BD.

Large longitudinal studies of bipolar offspring have been conducted worldwide, Furthermore, we still lack reliable methods of clearly differentiating between unipolar and bipolar depression.

The staging model of BD suggests that episodes of minor mood disturbances in late childhood followed by major mood episodes in adolescence precede the onset of mania.

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