Behaviour and psychopathology

What are antecedents of bipolar disorder?

Antecedents, such as behavioural disturbances and psychopathology, are deviations in development that may become evident during childhood or adolescence. The presence of these deviations may foreshadow the later development of bipolar disorder, however most children who exhibit these antecedents do not develop the disorder. Studies exploring antecedents are ideally based on representative, population-based samples that follow the group from birth through childhood and adolescence to adulthood.

What is the evidence from long-term studies for behavioural disturbances and psychopathology as antecedents of bipolar disorder?

Moderate quality evidence suggests an increased risk of bipolar disorder in adulthood with a childhood history of attention problems (including ADHD), aggressive behaviour (but not irritability), internalising or externalising behaviour, social isolation, or peer rejection. There may also be an increased risk of bipolar disorder with prior conduct or oppositional defiant disorder, disruptive or criminal behaviour, impulsivity, or anxiety disorders (e.g. generalised, separation, panic, PTSD).

People with a history of mood swings, subclinical depression or mania, cyclothymic disorder, higher frequency and loading of depression, early onset of depression disorders or episodes, or psychotic symptoms (particularly if accompanied by depression), may also be at an increased risk of developing bipolar disorder.

October 2021

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Last updated at: 3:14 pm, 29th March 2022
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