Early-Onset Bipolar Disorder

Summary: There is considerable controversy over the clinical presentation of EOBP, particularly its core symptoms, and hence the prevalence. Untreated early-onset bipolar disorder is associated with higher rates of rapid cycling, more comorbidity, and more severe mania and depression than adult-onset bipolar disorder. It is important to make the correct diagnosis of bipolar disorder early in its course. Pharmacological treatment in the acute stage with atypical antipsychotics and later mood stabilizers, including lithium, is important. Psychological treatments with CBT and family therapy including psycho-education are also indicated. Unfortunately evidence to date suggests that early age at onset predicts a longer time to first pharmacological treatment. EOBP is associated with suicide attempts and completed suicide. Longitudinal studies point to early onset, diagnosis of bipolar disorder not otherwise specified, long illness duration, low socioeconomic status, and family history of mood disorders being associated with poorer outcomes. © 2011 John Wiley & Sons, Ltd.