Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities
Abstract
:1. Introduction
2. Methods
2.1. Data Source and Survey Design
2.2. Study Variables
2.2.1. Demographic, Visit and Prescribing Characteristics
2.2.2. Diagnosis
2.2.3. Psychotropic Medications
2.3. Analytical Plan
3. Results
3.1. Recent Trends in PBD Office Visits, PBD Subtypes and Antipsychotic Medication Regimens
Characteristic | PBD with behavioral comorbidities | PBD without behavioral comorbidities | |||
---|---|---|---|---|---|
N | WC% | N | WC% | p Value | |
Total | 162 | 156 | |||
Bipolar NOS | 96 | 60.8 | 68 | 45.3 | 0.02 |
Bipolar I & II | 66 | 39.2 | 88 | 54.7 | |
Gender | |||||
Male | 119 | 69.7 | 73 | 46.5 | <0.001 |
Female | 43 | 30.3 | 83 | 53.5 | |
Age group, years | |||||
2–9 | 36 | 19.1 | 13 | 7.5 | <0.0001 |
10–14 | 70 | 46.1 | 39 | 24.0 | |
15–19 | 56 | 34.8 | 104 | 68.5 | |
Race/Ethnicity | |||||
White | 131 | 82.9 | 126 | 81.6 | NS |
Non-White | 31 | 17.2 | 30 | 18.4 | |
Payment type | |||||
Private | 71 | 45.0 | 91 | 60.5 | 0.03 |
Public | 91 | 55.0 | 65 | 39.6 | |
Type of Practice | |||||
Psychiatry | 148 | 85.1 | 132 | 75.3 | NS |
Non-Psychiatry | 14 † | 14.9 | 24 † | 24.7 | |
Region | |||||
North-East | 23 † | 13.6 | 37 | 12.2 | NS |
Mid-West | 54 | 27.9 | 35 | 13.1 | |
South | 38 | 30.9 | 36 | 13.8 | |
West | 47 | 27.6 | 48 | 14.8 | |
Prescribed psychotropic medications | |||||
Any psychotropic visit | 151 | 94.6 | 147 | 92.8 | NS |
Antipsychotics | 105 | 59.6 | 97 | 61.3 | NS |
Antidepressants | 39 | 21.0 | 65 | 41.6 | 0.001 |
Anxiolytics & Hypnotics | 6 † | 3.4 | 15 † | 11.5 | 0.01 |
Lithium | 17 † | 9.7 | 17 † | 9.7 | NS |
Alpha-agonist | 16 † | 8.3 | 5 † | 3.6 | NS |
Anticonvulsant | 68 | 44.7 | 66 | 40.2 | NS |
Stimulants | 104 | 67.8 | 14 † | 9.4 | <0.0001 |
PBD with behavioral comorbidities | PBD without behavioral comorbidities | ||||
---|---|---|---|---|---|
ATP regimens | N | WC% | N | WC% | p Value |
ATP monotherapy | 10 † | 4.2 | 29 † | 19.7 | <0.001 |
ATP + ≥1 concomitant psychotropic classes | 95 | 41.2 | 68 | 34.9 | |
ATP + concomitant stimulant | 72 | 19.5 | 8 † | 2.7 | <0.0001 |
ATP + concomitant ATC-MS | 38 | 10.4 | 38 | 12.2 | NS |
ATP + concomitant ATD | 28 † | 7.2 | 36 | 12.2 | NS |
3.2. Multivariable Analyses
Variable | AOR | 95% CI |
---|---|---|
Diagnosis (reference: Bipolar I & II) | ||
Bipolar NOS | 2.3 | 1.3–4.1 |
Gender (reference: female) | ||
Male | 2.3 | 1.3–4.0 |
Age group (reference: 15–19 years) | ||
2–9 years | 5.3 | 2.7–10.6 |
10–14 years | 3.7 | 1.8–7.4 |
Race-ethnicity (reference: white) | ||
Non white | 0.6 | 0.3–1.3 |
Payment (reference: public) | ||
Private | 0.6 | 0.3–1.0 |
4. Discussion
4.1. Limitations
4.2. Future Research and Practice Directions
5. Conclusions
Conflicts of Interest
References
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Rajakannan, T.; Zito, J.M.; Burcu, M.; Safer, D.J. Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities. J. Clin. Med. 2014, 3, 310-322. https://doi.org/10.3390/jcm3010310
Rajakannan T, Zito JM, Burcu M, Safer DJ. Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities. Journal of Clinical Medicine. 2014; 3(1):310-322. https://doi.org/10.3390/jcm3010310
Chicago/Turabian StyleRajakannan, Thiyagu, Julie M. Zito, Mehmet Burcu, and Daniel J. Safer. 2014. "Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities" Journal of Clinical Medicine 3, no. 1: 310-322. https://doi.org/10.3390/jcm3010310