ABSTRACT
OBJECTIVE: A priority for research on manic-depressive or bipolar I disorder (BPI) for children and adolescents has been to search for early predictors of the illness. METHOD: Medical record data were reviewed and systematically coded for a sample of 58 adult patients (32 males/26 females) with confirmed diagnoses of BPI to identify prodromal features and possible patterns of symptoms from the Amish Study. RESULTS: The most frequently reported symptoms included episodic changes in mood (depressed and irritable) and energy plus anger dyscontrol, with no significant gender differences. A progression of ages is seen for the most commonly reported symptoms prior to age 16. The time interval was 9 to 12 years between appearance of the first symptoms and onset of a documented BPI syndrome. CONCLUSIONS: The data suggest testable hypotheses about specific symptoms and behaviors that may be useful for the early detection of children at highest risk for developing manic-depressive disorder.
Subject(s)
Bipolar Disorder/diagnosis , Patient Admission , Adolescent , Adult , Bipolar Disorder/psychology , Child , Disease Progression , Female , Humans , Male , Personality Assessment , Prognosis , Retrospective Studies , Risk FactorsABSTRACT
An analysis of the segregation of restriction fragment length polymorphisms in an Old Order Amish pedigree has made it possible to localize a dominant gene conferring a strong predisposition to manic depressive disease to the tip of the short arm of chromosome 11.
Subject(s)
Bipolar Disorder/genetics , Chromosomes, Human, Pair 11 , Genetic Markers , Adolescent , Adult , Bipolar Disorder/epidemiology , Bipolar Disorder/ethnology , Christianity , DNA/genetics , Ethnicity , Humans , Pedigree , Pennsylvania , Polymorphism, Restriction Fragment Length , Religion and MedicineABSTRACT
All suicides were ascertained for a 100-year period (1880 to 1980) in a study of mental illness among the Old Order Amish. The majority (92%) of the 26 cases were diagnosed with a major affective disorder and were situated in multigenerational families with heavy loading for bipolar, unipolar, and other affective-spectrum illnesses. The suicides clustered in four primary pedigrees, and the role of inheritance was suggested by the way in which suicides followed the distribution of affective disorders in these kinship lines. We believe these extended pedigrees provide presumptive evidence of genetic factors in both suicides and affective disorders.
Subject(s)
Affective Disorders, Psychotic/genetics , Religion and Medicine , Suicide/epidemiology , Affective Disorders, Psychotic/epidemiology , Affective Disorders, Psychotic/mortality , Bipolar Disorder/genetics , Christianity , Depressive Disorder/genetics , Female , Humans , Male , Pedigree , Pennsylvania , Retrospective Studies , Risk , Seasons , Suicide/psychologyABSTRACT
A psychiatric condition disabling to persons in the fifth and sixth decades is described. Approximately 51 per cent of nearly 1,000 Social Security Disability applicants sampled presented a wide variety of somatic and psychological complaints, but no severe psychiatric disorder. This group is characterized by inability to continue gainful employment. Commencement of full-time employment before age 16 years (59 per cent) and level of education were the only significant differences between this group and psychotic applicants; another 33 per cent began full-time work before age 20 years. 88-5 per cent of the families of these persons remained intact until after they began work. Apparently, being thrust into the responsibilities of adulthood earlier than their peers contributed to the early disability.
