Evolution of bipolar disorders in adolescents: About 30 cases

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Imen Hadjkacem
Héla Ayadi
Adel Walha
Khaoula Khmekhem
Yousr Moalla
Farhat Ghribi

Abstract

Background: Bipolar disorders in adolescence are of a great importance, partly because of the relapsing character of this disorder and its impact in terms of psychosocial adjustment.
aim: To study the evolution of bipolar disorders in adolescents.
methods: We conducted a descriptive and retrospective survey on 30 adolescents followed in the child and adolescent psychiatry department of Sfax for bipolar disorders diagnosed according to the DSM-IV TR criteria.
results: The average number of the thymic episodes /year was 1.36±0.75. The average duration of the maniac episodes was 39. 75 day±24.79 and that of the depressive episodes was 78.75 days ± 43.73. The average duration of the inter critical intervals was 13.78 months ±11. 29. The complete remission was noted in 42.8% of the cases whereas the passage to chronicity was noticed in 3.6% of the cases. The family adaptation was satisfactory in 63.3% of the cases whereas the repercussion of the disorder on the school level was obvious. The social adaptation was non satisfactory in 53.3% of the cases. The suicide attempts were found in 10% of the cases.
Conclusion : The findings of the present study justify an early identification of bipolar disorders in adolescents as well as the initiation of appropriate therapy. The early intervention will permit to reduce the duration and the severity of the episodes. It will also limit the deleterious impact on the life of the subject and decrease the risk of suicide, which seems to be raised when the subject is not or is badly treated.

Keywords:

Adolescent - Evolution - Impact - Bipolar disorder

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References

  1. Goodwin FK, Jamison KR. Manic depressive illness. New York: Oxford University Press, 1990.
  2. Corcos M, Bocheraeau D, Jeammet P. Les troubles maniacodépressifs à l'adolescence. Paris, Masson ; 1999.
  3. Lish JD, Dime Meenan S, Whybrow PC, Price RA, Hirschfeld PMA. The national depressive and manic depressive Association (DMDA) survey of bipolar members. J Affect Disord 1994; 31: 281-94.
  4. Moalla Y, Ayedi H, B Ayed M, et al. Spécificités des troubles Maniaco-dépressifs débutant à l'adolescence. Arabpsynet E. Journal (revue électronique) 2007; 15.
  5. Walter M, Genest P. Les complications du trouble bipolaire. L'encéphale 2006; 32: 515-8, cahier 2.
  6. Geller B, Ziemerman B, Williams M et al. Diagnostic characteristics of 93 cases of a prepubertal and early adolescent bipolar disorder phenotype by gender, puberty and comorbid attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2000 ; 10 :157-64.
  7. Spurkland I., Vandvik I.H. Rapid cycling depression in adolescence. Acta Psychiatr. Scand 1989; 80:60-63.
  8. Wehr TA, Sack DA, Rosenthal NE, Cowdry RW. Rapid cycling affective disorder: Contributing factors and treatment responses in 51 patients. Am J Psychiatry 145: 179-89.
  9. Bellivier F. Évolution du trouble bipolaire. L'encéphale 2006 ; 32 : 506-11, cahier 2.
  10. Wehr TA, Goodwin FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry 1987 ; 144 :1403-11.
  11. Angst J, Sellaro R. Historical perspective and natural history of bipolar disorder. Biol Psychiatry 2000; 48:445-57.
  12. Coryell W, Endicott J, Keller M. Rapid cycling affective disorder. Demographics, diagnosis, family history, and course. Arch Gen Psychiatry 1992; 49: 126- 31.
  13. Strober MA. La maladie bipolaire. In Mouren-Siméoni M.C., R.G.Klein. Les dépressions chez l'enfant et l'adolescent : Faits et questions ; expansions scientifiques Publications 1997 : 187-196.
  14. Carlson GA, Kelly KL. Manic symptoms in psychiatrically hospitalized children- What do they mean? J Affect Disord 1998; 51:123-35.
  15. Carter TD, Mundo E, Paikh SV, Hennedy JL. Early age at onset as a risk factor for poor outcome of bipolar disorder. J Psychiatr Res 2003; 37: 297-303.
  16. Delamilleure P. Aspects pronostiques des troubles bipolaires. L'Encéphale 2006 ; 32 : 21-4, Cahier 2.
  17. Biederman J, Mick E, Faraone SV et al. Pediatric mania: a developmental subtype of bipolar disorder? Biol Psychiatry 2000 ; 48 : 458-66.
  18. Schurhoff F, Bellivier F, Jouvent R, et al. Early and late onset bipolar disorders: two differnt forms of manic-depressive illness? J. Affect Disord 2000 ; 58 :215-21.
  19. Sculzet TG, Muller DJ, Krauss H et al. Further evidence for age of onset being an indicator for severity in bipolar disorder. J Affect Disord 2002; 68:343-5.
  20. Yildiz A, Sachs GS. Age onset of psychotic versus non psychotic bipolar illness in men and women. J Affect Disord 2003; 74:197- 201.
  21. DO. Taylor, DJ. Miklowitz. Bipolar Disorder in Childhood and Adolescence. Rev Bras Psiquiatr 2004; 26: 22-26.
  22. Soutullo C A, Canales I E, Wozniak J, Garrán PG, Quintana AF, Biederman J. Pediatric bipolar disorder in a Spanish sample: Features before and at the time of diagnosis. J Affect Disord 2009; 118: 39-47.
  23. Mc Cauley E, Mitchell JR, Burke P, Moss S. Cognitive attributes of depression in children and adolescents. J Consult Clin Psychol 1988; 56:903-8.
  24. Nolan SA, Flynn C, Garber J. Prospective relations between rejection and depression in young adolescents. J Pers Soc Psychol 2003; 85:745-55.
  25. Dumas JE. Les troubles de l'humeur. Psychopathologie de l'enfant et de l'adolescent. De Boeck et Larcier, 2007.
  26. Corcos M, Consoli A, Nicolas I, Clervoy P, Bocheraeau D, Jeammet P. Troubles maniaco-dépressifs à l'adolescence. EMC (Elsevier SAS, Paris), Psychiatrie/ Pédopsychiatrie 2006; 37-214-A-50.
  27. Carlson GA., Early onset bipolar disorder: clinical and research consideration. J Clin Child adolesc Psychol 2005; 34:333-43.
  28. Sherazi R, McKeon P, McDonough L, Daly I, Kennedy N. What's new? The clinical epidemiology of bipolar I disorder. Harv Rev Psychiatry 2006; 14 : 273-84
  29. Welner A, Welner Z, Fishman R. Psychiatric adolescent inpatients: a 10year follow-up. Arch Gen Psychiatry 1979; 36: 698-700.
  30. Brent DA, Perper JA, Moritz G et al. Suicide in affectively ill adolescents: a case control study. J Affect Disord 1994; 31:193- 202.
  31. Galfalvy H, Oquendo MA, Carballo JJ, et al. Clinical predictors of suicidal acts after major depression in bipolar disorder: A prospective study. Bipolar Disord 2006; 8: 586-95.
  32. Goldstein TR, Birmaher B, Axelson D, et al. History of suicide attempt in pediatric bipolar disorder: Factors associated with increased risk. Bipolar Disord 2005; 7:525-35.
  33. Kochman F, Ferrari P, Hantouche EG, Akiskal H. Les troubles bipolaires chez l'adolescent. In Ferrari P. et al. Actualités en psychiatrie de l'enfant et de l'adolescent. Paris, Flammarion; 2001: 282- 290.