ArticleBipolar disorders2014
Type and duration of subsyndromal symptoms in youth with bipolar I disorder prior to their first manic episode.
Article in Bipolar disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Can We Predict Psychosis Outside the Clinical High-Risk State? A Systematic Review of Non-Psychotic Risk Syndromes for Mental Disorders.Schizophrenia bulletin · 2018Pooled it
- Meta-analysis of the Interval between the Onset and Management of Bipolar Disorder.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2017Pooled it
- Fish oil supplementation alters emotion-generated corticolimbic functional connectivity in depressed adolescents at high-risk for bipolar I disorder: A 12-week placebo-controlled fMRI trial.Bipolar disorders · 2022Trial
- Effects of Fish Oil Monotherapy on Depression and Prefrontal Neurochemistry in Adolescents at High Risk for Bipolar I Disorder: A 12-Week Placebo-Controlled Proton Magnetic Resonance Spectroscopy Trial.Journal of child and adolescent psychopharmacology · 2020Trial
- A Multi-Dimensional and Integrative Approach to Examining the High-Risk and Ultra-High-Risk Stages of Bipolar Disorder.EBioMedicine · 2015Trial
- Creativity and transition to bipolar disorder: a prospective analysis from the early-bipolife study.International journal of bipolar disorders · 2025Article
- Catching the Storm Before It Breaks: Advancing Early Diagnosis and Intervention in Bipolar Disorder.Life (Basel, Switzerland) · 2025Review
- Neurostructural Differences Associated With Prodromal Mania Symptoms in Children.Brain and behavior · 2025Review
- Factors associated with suicide attempts in the antecedent illness trajectory of bipolar disorder and schizophrenia.International journal of bipolar disorders · 2023Article
- Neurobehavioral Reward and Sleep-Circadian Profiles Predict Present and Next-Year Mania/Hypomania Symptoms.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2023Article
- Psychopathological Dissection of Bipolar Disorder and ADHD: Focussing on Racing Thoughts and Verbal Fluency .Neuropsychiatric disease and treatment · 2023Article
- Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study.Frontiers in psychiatry · 2023Article
- Prodromal phase: Differences in prodromal symptoms, risk factors and markers of vulnerability in first episode mania versus first episode psychosis with onset in late adolescence or adulthood.Acta psychiatrica Scandinavica · 2022Article
- Generalizing the Prediction of Bipolar Disorder Onset Across High-Risk Populations.Journal of the American Academy of Child and Adolescent Psychiatry · 2021Article
- Clinical Risk Constellations for the Development of Bipolar Disorders.Medicina (Kaunas, Lithuania) · 2021Review
- Early detection of bipolar disorders and treatment recommendations for help-seeking adolescents and young adults: Findings of the Early Detection and Intervention Center Dresden.International journal of bipolar disorders · 2021Article
- Clinical characteristic of prodromal symptoms between bipolar I and II disorder among Chinese patients: a retrospective study.BMC psychiatry · 2021Article
- The association between manic symptoms in adolescence and preschool symptoms: The importance of family history.Bipolar disorders · 2021Article
- Functional Impairment and Clinical Correlates in Adolescents with Bipolar Disorder Compared to Healthy Controls. A Case-control Study.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2020Article
- Improving early recognition and intervention in people at increased risk for the development of bipolar disorder: study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife).International journal of bipolar disorders · 2020Article
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
Abstract
objectivesThe aim of the present study was to systematically evaluate the prodrome to mania in youth.
methodsNew-onset/worsening symptoms/signs of ≥ moderate severity preceding first mania were systematically assessed in 52 youth (16.2 ± 2.8 years) with a research diagnosis of bipolar I disorder (BD-I). Youth and/or caregivers underwent semi-structured interviews, using the Bipolar Prodrome Symptom Scale-Retrospective.
resultsThe mania prodrome was reported to start gradually in most youth (88.5%), with either slow (59.6%) or rapid (28.8%) deterioration, while a rapid-onset-and-deterioration prodrome was rare (11.5%). The manic prodrome, conservatively defined as requiring ≥ 3 symptoms, lasted 10.3 ± 14.4 months [95% confidence interval (CI): 6.3-14.4], being present for ≥ 4 months in 65.4% of subjects. Among prodromal symptoms reported in ≥ 50% of youth, three were subthreshold manic in nature (irritability: 61.5%, racing thoughts: 59.6%, increased energy/activity: 50.0%), two were nonspecific (decreased school/work functioning: 65.4%, mood swings/lability: 57.7%), and one each was depressive (depressed mood: 53.8%) or subthreshold manic/depressive (inattention: 51.9%). A decreasing number of youth had ≥ 1 (84.6%), ≥ 2 (48.1%), or ≥ 3 (26.9%) 'specific' subthreshold mania symptoms (i.e., elation, grandiosity, decreased need for sleep, racing thoughts, or hypersexuality), lasting 9.5 ± 14.9 months (95% CI: 5.0-14.0), 3.5 ± 3.5 months (95% CI: 2.0-4.9), and 3.0 ± 3.2 months (95% CI: 1.0-5.0) for ≥ 1, ≥ 2, or ≥ 3 specific symptoms, respectively.
conclusionsIn youth with BD-I, a relatively long, predominantly slow-onset mania prodrome appears to be common, including subthreshold manic and depressive psychopathology symptoms. This suggests that early clinical identification and intervention may be feasible in bipolar disorder. Identifying biological markers associated with clinical symptoms of impending mania may help to increase chances for early detection and prevention before full mania.
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