We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We studied the course of major mood disorders in the offspring of parents with well-characterised bipolar disorder prospectively for up to 15 years. All consenting offspring were assessed annually or anytime symptomatic. The participants began to develop major mood episodes in adolescence and not before. The index major mood episode was almost always depressive, as were the first few recurrences. Onsets and recurrences continued throughout the observation period into adulthood. We did not find evidence of pre-pubertal mania. In summary, adolescence marks the beginning of the high-risk period for major mood episodes related to bipolar disorder.
To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.
To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.
Email your librarian or administrator to recommend adding this journal to your organisation's collection.
| Type | Description | Title | |
|
Duffy et al. supplementary material |
* Views captured on Cambridge Core between 2nd January 2018 - 12th June 2018. This data will be updated every 24 hours.
Irwin Feinberg, Professor
10 February 2010
In their excellent prospective study of 207 high-risk children, Duffyet al 1 found no evidence for prepubertal mania. This should give considerable pause to American psychiatrists who diagnose mania in children as young as five years old. Moreover, Duffy et al found no onset of depression prior to age 12 years. It is now recognized that massive maturational brain changes occur during adolescence. The changes in sleep EEG are particularly prominent and were an important stimulus to the modelof adolescent brain reorganization driven by synaptic pruning 2; a corollary of this hypothesis was that errors in post-natal brain developmental processes might cause mental illness.
We are carrying out a longitudinal study of sleep EEG in normal children aimed at defining the trajectories of adolescent brain reorganization. Our results 3 bear on the findings of Duffy et al. NREM delta power is unchanged between ages 6 and 11.5 years. It begins a massive decline at 11.5-12 years, falling 65% by age 17, when the decline slows markedly. Thus, the onset of mood disorders in Duffy et al’s subjects begins around the time that delta starts its rapid developmental change.
NREM delta EEG appears to reflect frontal lobe electrophysiology. Abnormalities in the functional development of frontal cortex could impairboth neural integration and emotional control. Both schizophrenia and major mood disorders have their onsets during or shortly after the period of adolescent brain reorganization. Since pubertal development is taking place at the same time, it is tempting to attribute adolescent brain changes to sexual maturation. However, we have demonstrated 4 that NREM delta maturation is strongly related to age when sexual maturation is statistically controlled; conversely, when age is controlled, the delta decline is unrelated to pubertal changes.
The increasing research on adolescent brain development underlines the importance of defining accurately, as Duffy et al are doing, the onsetand trajectories of psychiatric disorders.
References
1.Duffy, A., Alda, M., Hajek, T. & Grof, P. Early course of bipolar disorder in high-risk offspring: prospective study. Br J Psychiatry 2009; 195, 457-458.
2.Feinberg, I. Schizophrenia: caused by a fault in programmed synaptic elimination during adolescence? Journal of Psychiatric Research 1982/1983; 17, 319-334.
3.Campbell, I. G. & Feinberg, I. Longitudinal trajectories of non-rapid eye movement delta and theta EEG as indicators of adolescent brain maturation. Proceedings of the National Academy of Sciences of the United States of America 2009; 106, 5177-5180.
4.Feinberg, I., Higgins, L. M., Khaw, W. Y. & Campbell, I. G. The adolescent decline of NREM delta, an indicator of brain maturation, islinked to age and sex but not to pubertal stage. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology 2006; 291, R1724-R1729. ... More
Conflict of interest: None Declared
Write a replyBack to top