Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression
Abstract Background Estimating the risk of developing bipolar disorder (BD) in children and adolescents (C&A) with depressive disorders is important to optimize prevention and early intervention efforts. We aimed to quantitatively examine the risk of developing BD from depressive disorders and i...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-01-01
|
| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933824018145/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584938376921088 |
|---|---|
| author | Gonzalo Salazar de Pablo Violeta Perez-Rodriguez Javier de Otazu Olivares Javier Camacho-Rubio Aditya Sharma Ana Catalán Josefien Breedvelt Claudia Aymerich Mihai Pop Carmen Moreno Ian Kelleher Jane Anderson Paolo Fusar-Poli Christoph U Correll Allan H. Young |
| author_facet | Gonzalo Salazar de Pablo Violeta Perez-Rodriguez Javier de Otazu Olivares Javier Camacho-Rubio Aditya Sharma Ana Catalán Josefien Breedvelt Claudia Aymerich Mihai Pop Carmen Moreno Ian Kelleher Jane Anderson Paolo Fusar-Poli Christoph U Correll Allan H. Young |
| author_sort | Gonzalo Salazar de Pablo |
| collection | DOAJ |
| description | Abstract
Background
Estimating the risk of developing bipolar disorder (BD) in children and adolescents (C&A) with depressive disorders is important to optimize prevention and early intervention efforts. We aimed to quantitatively examine the risk of developing BD from depressive disorders and identify factors which moderate this development.
Methods
In this systematic review and meta-analysis (PROSPERO:CRD42023431301), PubMed and Web-of-Science databases were searched for longitudinal studies reporting the percentage of C&A with ICD/DSM-defined depressive disorders who developed BD during follow-up. Data extraction, random-effects meta-analysis, between-study heterogeneity analysis, quality assessment, sub-group analyses, and meta-regressions were conducted.
Results
Thirty-nine studies were included, including 72,371 individuals (mean age=13.9 years, 57.1% females); 14.7% of C&A with a depressive disorder developed BD after 20.4–288 months: 9.5% developed BD-I (95% CI=4.7 to 18.1); 7.7% developed BD-II (95% CI=3.2% to 17.3%); 19.8% (95% CI=9.9% to 35.6%) of C&A admitted into the hospital with a depressive disorder developed BD. Studies using the DSM (21.6%, 95% CI=20.2% to 23.1%) and studies evaluating C&A with a major depressive disorder only (19.8%, 95% CI=16.8% to 23.1%) found higher rates of development of BD. Younger age at baseline, a history of hospitalization and recruitment from specialized clinics were associated with an increased risk of developing BD at follow-up. Quality of included studies was good in 76.9% of studies.
Conclusions
There is a substantial risk of developing BD in C&A with depressive disorders. This is particularly the case for C&A with MDD, DSM-diagnosed depressive disorders, and C&A admitted into the hospital. Research exploring additional predictors and preventive interventions is crucial.
|
| format | Article |
| id | doaj-art-83ef70844d5146308dde032bfccb7e48 |
| institution | Kabale University |
| issn | 0924-9338 1778-3585 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj-art-83ef70844d5146308dde032bfccb7e482025-01-27T10:02:33ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2024.1814Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regressionGonzalo Salazar de Pablo0https://orcid.org/0000-0002-6992-0767Violeta Perez-Rodriguez1https://orcid.org/0000-0002-2485-3054Javier de Otazu Olivares2https://orcid.org/0000-0003-2032-5657Javier Camacho-Rubio3https://orcid.org/0000-0003-0570-5440Aditya Sharma4https://orcid.org/0000-0003-4632-4521Ana Catalán5https://orcid.org/0000-0002-0418-7904Josefien Breedvelt6https://orcid.org/0000-0003-1864-1861Claudia Aymerich7https://orcid.org/0000-0003-0040-1608Mihai Pop8https://orcid.org/0009-0009-4242-5086Carmen Moreno9https://orcid.org/0000-0003-0541-4846Ian Kelleher10Jane Anderson11https://orcid.org/0009-0005-9519-100XPaolo Fusar-Poli12Christoph U Correll13https://orcid.org/0000-0002-7254-5646Allan H. Young14https://orcid.org/0000-0003-2291-6952Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, SpainDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UKSchool of Medicine, Universidad Nacional Pedro Henriquez Ureña, Santo Domingo, Dominican RepublicDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, SpainAcademic Psychiatry, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK National Specialist Adolescent Mood Disorders Service (NSAMS), Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UKDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto. Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III. Barakaldo, Bizkaia, SpainDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UKDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto. Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III. Barakaldo, Bizkaia, SpainEast London NHS Foundation Trust, London, UKDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, SpainCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK School of Medicine, University College Dublin, Dublin, Ireland Faculty of Medicine, University of Oulu, Oulu, Finland St John of God Hospitaller Services Group, Stillorgan, IrelandChild and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UKDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UKDepartment of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, GermanyMaudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UKAbstract Background Estimating the risk of developing bipolar disorder (BD) in children and adolescents (C&A) with depressive disorders is important to optimize prevention and early intervention efforts. We aimed to quantitatively examine the risk of developing BD from depressive disorders and identify factors which moderate this development. Methods In this systematic review and meta-analysis (PROSPERO:CRD42023431301), PubMed and Web-of-Science databases were searched for longitudinal studies reporting the percentage of C&A with ICD/DSM-defined depressive disorders who developed BD during follow-up. Data extraction, random-effects meta-analysis, between-study heterogeneity analysis, quality assessment, sub-group analyses, and meta-regressions were conducted. Results Thirty-nine studies were included, including 72,371 individuals (mean age=13.9 years, 57.1% females); 14.7% of C&A with a depressive disorder developed BD after 20.4–288 months: 9.5% developed BD-I (95% CI=4.7 to 18.1); 7.7% developed BD-II (95% CI=3.2% to 17.3%); 19.8% (95% CI=9.9% to 35.6%) of C&A admitted into the hospital with a depressive disorder developed BD. Studies using the DSM (21.6%, 95% CI=20.2% to 23.1%) and studies evaluating C&A with a major depressive disorder only (19.8%, 95% CI=16.8% to 23.1%) found higher rates of development of BD. Younger age at baseline, a history of hospitalization and recruitment from specialized clinics were associated with an increased risk of developing BD at follow-up. Quality of included studies was good in 76.9% of studies. Conclusions There is a substantial risk of developing BD in C&A with depressive disorders. This is particularly the case for C&A with MDD, DSM-diagnosed depressive disorders, and C&A admitted into the hospital. Research exploring additional predictors and preventive interventions is crucial. https://www.cambridge.org/core/product/identifier/S0924933824018145/type/journal_articleadolescentsbipolar disorderchildrendepressive disordersmeta-analysisprevention |
| spellingShingle | Gonzalo Salazar de Pablo Violeta Perez-Rodriguez Javier de Otazu Olivares Javier Camacho-Rubio Aditya Sharma Ana Catalán Josefien Breedvelt Claudia Aymerich Mihai Pop Carmen Moreno Ian Kelleher Jane Anderson Paolo Fusar-Poli Christoph U Correll Allan H. Young Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression European Psychiatry adolescents bipolar disorder children depressive disorders meta-analysis prevention |
| title | Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression |
| title_full | Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression |
| title_fullStr | Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression |
| title_full_unstemmed | Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression |
| title_short | Development and predictors of bipolar disorder in children and adolescents with depressive disorders: a systematic review, meta-analysis, and meta-regression |
| title_sort | development and predictors of bipolar disorder in children and adolescents with depressive disorders a systematic review meta analysis and meta regression |
| topic | adolescents bipolar disorder children depressive disorders meta-analysis prevention |
| url | https://www.cambridge.org/core/product/identifier/S0924933824018145/type/journal_article |
| work_keys_str_mv | AT gonzalosalazardepablo developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT violetaperezrodriguez developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT javierdeotazuolivares developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT javiercamachorubio developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT adityasharma developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT anacatalan developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT josefienbreedvelt developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT claudiaaymerich developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT mihaipop developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT carmenmoreno developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT iankelleher developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT janeanderson developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT paolofusarpoli developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT christophucorrell developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression AT allanhyoung developmentandpredictorsofbipolardisorderinchildrenandadolescentswithdepressivedisordersasystematicreviewmetaanalysisandmetaregression |