Abstract
BackgroundMood elevation is common in adolescents and young adults. The aim of this study was to investigate the prevalence of a bipolar diagnosis and co-morbidity in individuals identified by online screening for experience of (hypo)manic symptoms in order to better define the common bipolar phenotype in young people.MethodsSurvey data regarding experience of (hypo)manic symptoms and occurrence of co-morbidities were analysed for 106 students satisfying criteria for probable bipolar syndrome (≥7 mood elevation symptoms plus problems on the Mood Disorder Questionnaire (MDQ)), 459 threshold bipolar students (≥7 symptoms only) and 637 controls (zero symptoms). Co-morbidities investigated included neuroticism, depression, substance misuse, gambling, health problems and medication use. Twenty-one students satisfying criteria for probable bipolar syndrome, 71 threshold bipolar students and 43 controls were interviewed with the Mini International Neuropsychiatric Interview-Plus for diagnoses of DSM-IV-TR bipolar disorder I, II or not otherwise specified (NOS).Results and discussionThere was a higher incidence of bipolar diagnosis in probable bipolar (62%) compared to threshold bipolar (34%) individuals. The probable bipolar group had increased risk of co-morbidity for neuroticism, depression, substance misuse, gambling, health problems and medication use, shared to a lesser extent by the threshold bipolar group. Self-report screening for mood elevation detects a bipolar phenotype common in young people. It provides a bridge to bipolar disorder of potential interest in understanding psychopathology, treatment and prevention.
Highlights
Mood elevation is common in adolescents and young adults
Mood elevation is a phenomenon which has the potential to bridge between DSM-5 categorical diagnoses and the Research Domain Criteria project (RDoC) launched by NIMH (Insel et al 2010)
The three groups were well matched for age and gender
Summary
Mood elevation is common in adolescents and young adults. The aim of this study was to investigate the prevalence of a bipolar diagnosis and co-morbidity in individuals identified by online screening for experience of (hypo)manic symptoms in order to better define the common bipolar phenotype in young people. Bipolar disorder is a serious and recurrent disease that is one of the leading causes of worldwide disability (Murray and Lopez 1997). The lifetime prevalence of bipolar disorder is around 4% to 5% (Merikangas et al 2007) if hypomania and other minor elated states are included in its definition (Akiskal et al 2000). Mood elevation is the core and defining psychopathology of bipolar disorder. When milder (hypomania or subsyndromal), it essentially modifies the major depression diagnosis, with which patients may present, or contributes to mood instability.
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