Diagnostic stability in children and adolescents with bipolar disorder, a nationwide register-based study

Mathilde Frahm Laursen; Rasmus W. Licht; Christoph U. Correll; Tobias Kallehauge; Ann-Eva Christensen; Maria Rodrigo-Domingo; René Ernst Nielsen

doi:10.1186/s40345-020-0179-3

International Journal of Bipolar Disorders

Table 2 Bipolar disorder (BD) in children and adolescents with and without diagnostic change after 3 years of follow-up (N = 478)

From: Diagnostic stability in children and adolescents with bipolar disorder, a nationwide register-based study

	Group with unchanged BD (N = 412)	Group with diagnostic change (N = 66)	RR (95% CI)	p value
	N (%)	N (%)	RR (95% CI)	p value
Sex				0.038
Female	244 (89.1%)	30 (10.9%)
Male	168 (82.4%)	36 (17.6%)	1.61 (1.03; 2.53)
Family history of psychiatric disorder				0.310
No	–^a (87%)	–^a (13%)
Yes	–^a (84%)	–^a (16%)	1.27 (0.80; 2.03)
Family history of BD				0.629
No	–^a (86%)	–^a (14%)
Yes	–^a (88%)	–^a (12%)	0.82 (0.37; 1.18)
Substance abuse (total)				0.286
No	373 (86.7%)	57 (13.3%)
Yes	39 (81.3%)	9 (18.8%)	1.41 (0.75; 2.68)
Substance abuse of other than alcohol and cannabis				0.001
No	397 (87.3%)	58 (12.7%)
Yes	15 (65.2%)	8 (34.8%)	2.73 (1.48; 5.02)
Diagnostic setting				0.015
Outpatient or ER	259 (89.3%)	31 (10.7%)
Inpatient	153 (81.4%)	35 (18.6%)	1.74 (1.11; 2.73)
Psychotic BD at index				0.055
No	340 (87.6%)	48 (12.4%)
Yes	72 (80.0%)	18 (20.0%)	1.62 (0.99; 2.64)
Index BD prior to 2005				0.988
No	300 (86.2%)	48 (13.8%)
Yes	112 (86.2%)	18 (13.8%)	1.00 (0.61; 1.66)
Index BD < 13 years
No	384 (86.1%)	62 (13.9%)
Yes	> 27 (–%)¹	< 5 (–%)¹	–^a	–^a
Latest psychiatric diagnosis prior to BD
Schizophrenia or related diagnosis				< 0.0001
No	355 (90.6%)	37 (9.4%)
Yes	57 (66.3%)	29 (33.7%)	3.57 (2.33; 5.47)
Affective disorders				0.568
No	313 (86.7%)	48 (13.3%)
Yes	99 (84.6%)	18 (15.4%)	1.16 (0.70; 1.91)
Substance abuse				0.655
No	381 (86.4%)	60 (13.6%)
Yes	31 (83.8%)	6 (16.2%)	1.19 (0.55; 2.57)
Other psychiatric disorders				0.134
No	191 (88.8%)	24 (11.2%)
Yes	221 (84.0%)	42 (16.0%)	1.43 (0.90; 2.29)
Information about parents (N = 473)
Schizophrenia or related diagnosis				0.003
No	–^a (88%)	–^a (12%)
Yes	–^a (72%)	–^a (28%)	2.26 (1.32; 3.90)
Affective disorders				0.680
No	–^a (87%)	–^a (13%)
Yes	–^a (85%)	–^a (15%)	1.12 (0.66; 1.91)
Substance abuse				0.928
No	–^a (86%)	–^a (14%)
Yes	–^a (86%)	–^a (14%)	1.03 (0.55; 1.92)
Other psychiatric disorders				0.438
No	–^a (86%)	–^a (14%)
Yes	–^a (> 55%)	–^a (< 45%)	1.64 (0.47; 5.68)

	Mean (SD)	Mean (SD)	RR (95% CI)	p-value
Age at first ever BD diagnosis (N = 478)	15.9 (2.1)	16.0 (2.1)	1.01 (0.91; 1.13)	0.857
Age at first psychiatric contact (N = 478)	14.4 (3.5)	14.0 (4.3)	0.98 (0.92; 1.04)	0.465

^aThe exact numbers could not be reported in order to comply with the data protection rules set by Statistics Denmark in order to avoid allowing identification of individual patients in cells containing ≤ 5 patients

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