Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course
Accepted 9 September 1994.
ABSTRACT
Objective
The purpose of this study was to examine the prevalence, clinical characteristics, and mental health treatment services utilization of adolescents with bipolar disorders and manic symptoms.
Method
Structured diagnostic interviews were administered to a representative community sample of 1,709 older adolescents (aged 14 through 18 years).
Results
The lifetime prevalence of bipolar disorders (primarily bipolar II disorder and cyclothymia) was approximately 1%. An additional 5.7% of the sample reported having experienced a distinct period of abnormally and persistently elevated, expansive, or irritable mood even though they never met criteria for bipolar disorder (“core positive” subjects). The rate of manic symptoms in these subjects was similar to that reported in clinical samples, and the course of bipolar disorder was relatively chronic. Compared with adolescents with a history of major depression (n = 316) and a “never mentally ill” group (n = 845), the bipolar and core positive subjects both exhibited significant functional impairment and high rates of comorbidity (particularly with anxiety and disruptive behavior disorders), suicide attempts, and mental health services utilization.
Conclusions
These data highlight the clinical and public health significance of even the milder and subthreshold cases of bipolar disorder in adolescence.
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Dr. Levinsohn and Mr. Seeley are with the Oregon Research Institute, Eugene, and Dr. Klein is with the Department of Psychology, State University of New York at Stony Brook
Reprint requests to Dr. Lewinsohn, Oregon Research Institute, 1715 Franklin Blvd., Eugene, OR 97403-1983
This research was supported in part by NIMH awards MH40501 and MH50522.
ABSTRACT