PHENOMENOLOGY OF ADOLESCENT AND ADULT MANIA IN HOSPITALIZED-PATIENTS WITH BIPOLAR DISORDER

Objective: Although available data suggest that bipolar disorder most commonly begins in adolescence, it has often been underrecognized and misdiagnosed in this age group. The authors hypothesized that this mig ht in part be because adolescent mania is phenomenologically different from adult mania. To test this hypothesis, they compared a cohort of adolescents hospitalized for acute mania with a group of hospitalized acutely manic adults. Method: The authors compared symptomatic differe nces between 40 adolescent (ages 12-18 years) and 88 adult (ages 19-45 years) bipolar patients hospitalized for acute mania. They also compa red the two groups with respect to demographic characteristics, psychi atric comorbidity, family history, and short-term outcome. Results: Co mpared with adults, adolescent patients displayed a significantly high er rate of mixed bipolar disorder and a significantly lower rate of ps ychotic features (by DSM-III-R criteria), as well as higher ratings fo r many depressive symptoms (including suicidality and depressed mood) and lower ratings for thought disorder an delusions. Adolescents also displayed a significantly lower rate of substance abuse and significan tly higher rates of familial mood disorder and drug abuse or dependenc e. Conclusions: Significant differences were found in the phenomenolog y of adolescent and adult mania in this study. The reasons for these d ifferences are not known. Possible explanations include artifact due t o methodological limitations and differences between adolescents and a dults in familial loading for mood or substance use disorders or in de velopmental or maturational stage.