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Table 1 Potential child and adolescent risk factors of adult bipolar disorder (BPD) compared with major depression disorder (MDD) or no mood episodes in adulthood

From: Early risk factors for adult bipolar disorder in adolescents with mood disorders: a 15-year follow-up of a community sample

Potential risk factors in childhood/adolescence A B C A vs. C A vs. B
BPD in adulthood MDD in adulthood No mood episode in adulthood OR (95% CI) OR (95% CI)
n = 22 (%) n = 104 (%) n = 68 (%)
Female 19 (86) 87 (84) 51 (75) 2.11 (0.56-8.03) 1.24 (0.33-4.65)
Mental disorders (DICA-R-A):      
Separation Anxiety disorder 10 (46) 40 (39) 20 (29) 2.00 (0.75-5.37) 1.33 (0.53-3.37)
Social Phobia 2 (9) 17 (16) 9 (13) 0.66 (0.13-3.29) 0.51 (0.11-2.40)
GAD 8 (36) 47 (45) 14 (21) 2.20 (0.77-6.29) 0.69 (0.27-1.79)
Panic Disorder 5 (23) 16 (15) 5 (7) 3.71 (0.96-14.30) 1.62 (0.52-5.01)
Any anxiety disordera 15 (68) 71 (68) 35 (52) 2.02 (0.73-5.58) 1.00 (0.37-2.67)
OCD 4 (18) 27 (26) 12 (18) 1.04 (0.30-3.62) 0.63 (0.20-2.04)
PTSD - 6 (6) - - -
Eating disorders 2 (9) 5 (5) 4 (6) 1.60 (0.27-9.39) 1.98 (0.36-10.93)
Disruptive disorder (CD/ODD/ADHD) 13 (59) 30 (29) 20 (29) 3.47 (1.28-9.40)* 3.56 (1.38-9.21)**
Substance abuse 3 (14) 10 (10) 8 (12) 1.18 (0.29-4.92) 1.47 (0.37-5.85)
Mania episode symptoms:      
Elevated mood 5 (23) 34 (33) 25 (37) 0.51 (0.17-1.54) 0.61 (0.21-1.78)
Grandiosity 7 (32) 35 (34) 29 (43) 0.63 (0.23-1.74) 0.92 (0.34-2.46)
Irritability 2 (9) 7 (7) 4 (6) 1.60 (0.27-9.39) 1.39 (0.27-7.17)
Distractibility 1 (5) 14 (14) 9 (13) 0.31 (0.04-2.61) 0.31 (0.04-2.46)
Increased activity 6 (27) 31 (30) 19 (28) 0.97 (0.33-2.84) 0.88 (0.32-2.47)
Racing thoughts 4 (18) 18 (17) 9 (13) 1.46 (0.40-5.30) 1.06 (0.32-3.51)
Pressured speech 3 (14) 21 (20) 12 (18) 0.74 (0.19-2.89) 0.62 (0.17-2.31)
Decreased need of sleep 5 (23) 33 (32) 23 (34) 0.58 (0.19-1.76) 0.63 (0.22-1.86)
Depressive episode symptoms:      
Suicide attempt 4 (18) 25 (24) 15 (22) 0.79 (0.23-2.68) 0.70 (0.22-2.27)
Suicide ideation 15 (68) 63 (61) 35 (51) 1.55 (0.57-4.18) 1.37 (0.53-3.50)
Dysphoria 20 (91) 99 (95) 63 (93) 0.79 (0.14-4.41) 0.51 (0.91-2.79)
Anhedonia 17 (77) 80 (77) 41 (60) 2.24 (0.74-6.79) 1.02 (0.34-3.05)
Psychomotor inhibition 18 (82) 79 (76) 49 (72) 1.75 (0.52-5.83) 1.42 (0.44-4.60)
Fatigue 15 (68) 82 (79) 47 (69) 0.96 (0.34-2.69) 0.58 (0.21-1.58)
Worthlessness 20 (91) 84 (81) 43 (63) 5.81 (1.25-26.98)* 2.38 (0.51-11.03)
Trouble concentration 18 (82) 82 (79) 53 (78) 1.27 (0.37-4.34) 1.21 (0.37-3.93)
Sleep disturbances 12 (55) 52 (50) 32 (47) 1.35 (0.51-3.54) 1.20 (0.48-3.02)
Appetite disturbances 18 (82) 83 (80) 49 (72) 1.75 (0.52-5.83) 1.14 (0.35-3.72)
Psychotic symptoms 2 (9) 6 (6) 3 (4) 2.17 (0.34-13.89) 1.63 (0.31-8.69)
Somatic symptoms (≥5)b 11 (50) 30 (31) 11 (17) 4.82 (1.67-13.88)** 2.27 (0.89-5.80)
Long-term depressionc 14 (64) 54 (52) 23 (34) 3.42 (1.26-9.34)* 1.62 (0.63-4.19)
Family characteristics:      
Substance abuse in family 3 (14) 12 (12) 5 (7) 1.99 (0.44-9.10) 1.20 (0.31-4.66)
Violence in family 7 (32) 19 (18) 15 (22) 1.65 (0.57-4.78) 2.06 (0.74-5.76)
Death in family by accident 4 (18) 23 (22) 13 (19) 0.94 (0.27-3.25) 0.77 (0.24-2.51)
Family history of BPDd 5 (23) 8 (8) 3 (4) 6.37 (1.38-29.36)* 3.53 (1.03-12.08)*
Family history of MDDd 15 (68) 71 (68) 25 (37) 3.69 (1.32-10.27)* 0.99 (0.37-2.67)
Family history of BPD or MDDd 16 (73) 71 (68) 27 (40) 4.05 (1.41-11.65)** 1.24 (0.44-3.46)
  1. aSeparation Anxiety disorder, Social Phobia, GAD, or Panic Disorder.
  2. bThe number of individuals who completed the MINI interview and the SCL for somatic symptoms differed slightly (In the MDD group there are missing data for six persons and in the no-mood episode group for four persons).
  3. cLong-term depression was defined as major depression during most of the previous year, major depression followed by symptoms meeting the criteria for dysthymia, or major depression superimposed on a state of dysthymia.
  4. d1st and/or 2nd degree family history of BPD and/or MDD.
  5. MDD: Major depressive disorder; OCD: Obsessive-compulsive disorder; PTSD: Posttraumatic stress disorder; ADHD: Attention-deficit/hyperactivity disorder; CD: Conduct disorder; ODD: Oppositional defiant disorder; GAD: Generalized anxiety disorder. Note: *p < 0.05; **p < 0.01.