Brief Communication The Index Manic Episode in Juvenile-Onset Bipolar Disorder: The Pattern of Recovery

rospective studies of bipolar disorders (BDs) in children and adolescents are few and the findings conflict. While some studies report excellent recovery rates from index bipo-lar episodes (1,2), other studies report low recovery rates, ranging from 14 % to 65 % (3–6). No predictors of recovery were identified in any of these studies, with the exception of 1 study that reported longer episodes in those with comorbid attention-deficit hyperactivity disorder (ADHD) (3). This study examined the recovery pattern over a period of 6 months in subjects with index manic or mixed affective epi-sodes, assessed their level of global functioning, and at-tempted to identify predictors of recovery and functioning. 52 Can J Psychiatry, Vol 48, No 1, February 2003 Objective: Recent studies of patients with juvenile bipolar disorder report low rates of re-covery and high rates of chronicity. However, we lack data on the short-term outcome. This study examines the pattern of recovery from the index episode in an aggressively treated juvenile sample. Method: We assessed 25 subjects (< 16 years) with a diagnosis of mania, using the Diag-nostic Interview for Children and Adolescents-Revised) (DICA-R), Young Mania Rating Scale (YMRS), and Children’s Global Assessment Scale (CGAS) at intake and at 3 and 6 months. We studied the time taken to recover from the index episode, the level of function-ing, and the factors predicting them. Results: After 6 months, 24 (96%) subjects had recovered from the index manic episode. The median time to recovery was 27 days. Total episode length was significantly longer among those with previous affective episodes. Conclusions: The findings suggest that juvenile-onset mania has high rates of recovery and low rates of chronicity. These differences from the existing literature need further exploration. (Can J Psychiatry 2003:48:52–55) Author affiliations appear at the end of the article