Defining and validating bipolar disorder in the preschool period
Therefore, the person’s financial accounts or important relationships may be in such disarray as to lead to adverse outcomes, including loss of important friends and family support or connections, serious financial setbacks, job losses, legal problems, and homelessness.
Especially in older children and adolescents, bipolar disorder may be a more severe form with increased risk of suicide attempts and the adverse effects of the disorder can contribute to dysfunction in the school setting, potentially leading to expulsion or peer rejection.
The strongest predictors of bipolar prodrome appear to be baseline anxiety/depression with proximal affective lability and full or subsyndromal manic symptoms, increasing the risk of bipolar prodrome from 2% (baseline risk due to family history) to 49%.
An abnormal behavioral episode may be designated a bipolar disorder after the frequency and type of abnormal mood are considered.
Parental history of ADHD increases the risk of DMDD by 4 times that in control populations, however, risk of DMDD is 20 times higher in families where there are offspring with DMDD.
Comorbid diagnosis of autism spectrum disorder (ASD), especially with ADHD symptoms, are predictive of a more challenging clinical course that may require multiple different medications for remission.
Associated delusions frequently center on an expansive sense of self that goes well beyond narcissism (eg, believing oneself to have special powers or to be the chosen leader of the world or universe).Type II bipolar disorder (BPII) is diagnosed on the basis of at least 1 hypomanic episode.