Bipolar Spectrum Disorders: Longitudinal Factors Associated with Risk and Improvement

Dear Colleagues,

Bipolar disorder (BD) is a psychiatric illness that usually onsets before adulthood, affects on average 2% of the population, and is associated with high rates of suicidality, Substance Use Disorder (SUD), functional impairment, and morbidity [1–5]. Thus, it is important to identify the factors associated with the course and outcome of BD to inform treatment and prevention strategies. In the past decades of clinical research, we have learned much about the effects of variables ascertained at study intakes on the course of BD. Overall, poor prognosis has been associated with lifetime family history of BD and SUD [6], individual early childhood BD onset [7], history of exposure to negative life events (e.g., abuse) [8], severe mood symptoms [9], suicidality [2], psychosis [10], comorbid disorders (e.g., anxiety disorders) [11], lower socioeconomic status (SES) [12], and reduced psychosocial functioning [13]. While these findings are informative, with some exceptions, these variables are subject to change over time (e.g., comorbid disorders, SES), and these changes may affect the course of BD (e.g., increase the risk factors, or contribute to improvements). Indeed, the use of prospective longitudinal designs, including multiple assessment measures, risk calculators for mood recurrence and suicidality [14–16], predictors of new onsets (e.g., physical/sexual abuse, SUD) [6,17], and physical indicators for health concerns (e.g., inflammatory markers) [18], must be taken into context with effective treatments (e.g., psychosocial, psychopharmacological) [19,20] and other factors (e.g., family, individual) [12] which are associated with improvement. Papers addressing the topic of BD and related conditions are invited for this Special Issue, especially those utilizing a longitudinal research design, and focus on providing new insights on the course of BD.

References

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6. Goldstein, B. I.; Strober, M.A.; Axelson, D.A.; Goldstein, T. R.; Gill, M. K.; Hower, H.; Dickstein, D. P.; Hunt, J. I; Yen, S.; Kim, E. et al. Predictors of first-onset substance use disorders during the prospective course of bipolar spectrum disorders in adolescents. Am. Acad. Child. Adolesc. Psychiatry,2013, 52, 1026–1037.
7. Birmaher, B.; Gill, M. K.; Axelson, D. A.; Goldstein, B. I.; Goldstein, T. R.; Yu, H.; Liao, F.; Iyengar, S.; Diler, R. S.; Strober, M. A. et al. Longitudinal trajectories and associated baseline predictors in youth with bipolar spectrum disorders. AJP,2014, 171, 990–999.
8. Andreu Pascual, M.; Levenson, J. C.; Merranko, J. A.; Gill, M. K.; Hower, H.; Yen, S.; Strober, M. A.; Goldstein, T. R.; Ryan, N. D.; Goldstein, B. I. et al. The effect of traumatic events on the longitudinal course of youth with bipolar disorder. Affect. Disord.,2020, 274, 126–135.
9. Birmaher, B.; Gill, M. K.; Axelson, D. A.; Goldstein, B. I.; Goldstein, T. R.; Yu, H.; Liao, F.; Iyengar, S.; Diler, R. S.; Strober, M. A. et al. Longitudinal trajectories and associated baseline predictors in youth with bipolar spectrum disorders. AJP, 2014, 171, 990–999.
10. Shalev, A.; Merranko, J. A.; Gill, M. K.; Goldstein, T. R.; Liao, F.; Goldstein, B. I.; Hower, H.; Ryan, N. D.; Strober, M. A; Iyengar, S. et al. Longitudinal course and risk factors associated with psychosis in bipolar youth. Bipolar Disord., 2020, 22(2), 139–154.
11. Yen, S.; Stout, R.; Hower, H.; Killam, M. A.; Weinstock, L. M.; Topor, D. R.; Dickstein, D. P.; Hunt, J. I.; Gill, M. K.; Goldstein, T. R. et al. The influence of comorbid disorders on the episodicity of bipolar disorder in youth. Acta Psychiatrica Scandinavica, 2016, 133, 324–334.
12. Diler, R. S.; Merranko, J. A.; Hafeman, D. M.; Goldstein, T. R.; Goldstein, B. I.; Hower, H.; Gill, M. K.; Axelson, D. A.; Ryan, N. D.; Strober, M. A. et al. Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder. Affect. Disord., 2020, 302, 185–193.
13. Hower, H.; Lee, E. J.; Jones, R. N.; Birmaher, B.; Strober, M. A.; Goldstein, B. I.; Merranko, J. A.; Keller, M. B.; Goldstein, T. R.; Weinstock, L. M. et al. Predictors of longitudinal psychosocial functioning in bipolar youth transitioning to adults. Affect. Disord, 2019, 246, 578–585.
14. Birmaher, B.; Merranko, J. A.; Goldstein, T. R.; Gill, M. K.; Goldsein, B. I.; Hower, H.; Yen, S.; Hafeman, D. M.; Strober, M. A.; Diler, R. S. et al. A risk calculator to predict the individual risk of conversion from subthreshold bipolar symptoms to bipolar disorder I or II in youth. JAACP,2018, 57, 755–763.
15. Birmaher, B.; Merranko, J. A.; Gill, M. K.; Hafeman, D. A.; Goldstein, T. R.; Goldstein, B. I.; Hower, H.; Strober, M. A.; Axelson, D. A.; Ryan, N. D. et al. Predicting personalized risk of mood recurrences in youths and young adults with bipolar spectrum disorder. JAACAP, 2020, 59, 1156–1164.
16. Goldstein, T. R.; Merranko, J. A.; Hafeman, D. M.; Gill, M. K.; Liao, F.; Sewall, C. J. R.; Hower, H.; Weinstock, L. M.; Yen, S.; Goldstein, B. I. et al. A risk calculator to predict suicide attempts among individuals with early-onset bipolar disorder. Bipolar Disord, 2022, 24, 749–757.
17. Andreu Pascual, M.; Merranko, J. A.; Gill, M. K.; Levenson, J. C.; Hafeman, D. M.; Hower, H.; Yen, S.; Strober, M. A.; Goldstein, B. I.; Diler, R. S. et al. Risk factors preceding new onset abuse among youth with bipolar disorder: A longitudinal perspective analysis. Affect. Disord,2022, 300, 296–304.
18. Goldstein, B. I.; Lotrich, F.; Axelson, D. A.; Gill, M. K.; Hower, H.; Goldstein, T.R.; Fan, J.; Yen, S.; Diler, R. S.; Dickstein, D. P. et al. Inflammatory markers among adolescents and young adults with bipolar spectrum disorders. JCP, 2015, 76, 1556–1563.
19. Miklowitz, D. J.; Weintraub, M. J.; Walshaw, P. D.; Schneck, C. D.; Chang, K. D.; Merranko, J.; Singh, M. K. Early Family Intervention for Youth at Risk for Bipolar Disorder: Psychosocial and Neural Mediators of Outcome. Neuropharmacol., 2023, 21, 1379–1392
20. Hafeman, D. M.; Goldstein, T. R.; Strober, M. A.; Merranko, J. A.; Gill, M. K.; Liao, F.; Diler, R. S.; Goldstein, B. I.; Ryan, N. D.; Axelson D. A.; et al. Prospectively ascertained mania and hypomania among young adults with child- and adolescent-onset bipolar disorders. Bipolar Disord, 2021, 23, 463–473.

Dr. María Andreu Pascual
Prof. Heather Hower
Guest Editors

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• bipolar spectrum disorders
• major depressive disorder
• hypo/mania
• longitudinal studies
• risk factors
• outcomes
• suicidality
• psychosocial functioning
• psychosocial treatment
• psychopharmacology