More Than 70% of People with Bipolar Disorder Have Additional Psychiatric Illness
At the 2019 meeting of the International Society for Bipolar Disorders, researcher Kathleen R. Merikangas reviewed large scale community studies of people with bipolar disorder in multiple countries. She reported that more than 70% of people with bipolar disorder have three or more lifetime disorders, not just bipolar disorder.
Preliminary findings suggested that adolescents with bipolar disorder did not tend to have other disorders in addition to their bipolar disorder, but as they approached young adulthood these became more common. Merikangas concluded, “These findings suggest that early intervention may prevent the secondary comorbidity that is related to greater impairment, worse course and poorer treatment response in bipolar disorder.”
Editor’s Note: It is a major deficit that not only is there limited data on early intervention in general, but virtually none about early intervention in the face of multiple comorbidities. This lack of treatment knowledge means that the majority of people with bipolar disorder are facing challenges that could be mitigated if only the needed clinical treatment research were done.
Psychiatric Symptoms in Childhood Linked to Struggles in Adulthood
Psychiatric illness is one of the most common health problems among children. A study by William E. Copeland and colleagues in the journal JAMA Psychiatry indicates that psychiatric symptoms and diagnoses in childhood can lead to struggles with health, the legal system, personal finances, and social functioning in early adulthood, even if the psychiatric symptoms themselves do not last.
The study included 1420 participants from 11 mostly rural counties in North Carolina, who participated in structured interviews up to six times between the ages of 9 and 16 to determine the existence of psychiatric symptoms and diagnoses. Of these, 1273 were assessed three times during young adulthood, at the ages of 19, 21, and 24–26, for any evidence of social, legal, financial, or health problems.
Participants who had had a childhood psychiatric disorder were six times more likely to have at least one adverse outcome in adulthood compared to participants with no history of psychiatric problems, and nine times more likely to have two or more adverse outcomes in adulthood. Those participants who had psychiatric symptoms that were not sufficient for a particular diagnosis were still three times more likely to have at least one adverse outcome in adulthood, and five times more likely to have at least 2 adverse outcomes. The cumulative number of psychiatric disorders to which a participant was exposed was the best predictor of adverse outcomes in adulthood.
Even moderate psychiatric problems in childhood can disrupt a person’s transition to adulthood. However, early treatment and prevention can help reduce the long-term impact of psychiatric illness. Parents of children (aged 2–12) with mood and behavioral symptoms are welcome to join the Child Network, a system for collecting weekly ratings of their children’s symptoms and displaying them longitudinally for the child’s doctor.
