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Incidence of childhood-onset bipolar illness in the USA and Europe

Published online by Cambridge University Press:  02 January 2018

Robert M. Post*
Department of Psychiatry, George Washington University, Washington, DC, and Penn State College of Medicine, Hershey, Pennsylvania
David A. Luckenbaugh
Mood and Anxiety Disorder Program, National Institute of Mental Health, Bethesda, Maryland
Gabriele S. Leverich
Mood and Anxiety Disorder Program, National Institute of Mental Health, Bethesda, Maryland
Lori L. Altshuler
University of California, Los Angeles, Mood Disorders Research Program, and VA Medical Center, Los Angeles, California
Mark A. Frye
Department of Psychiatry, Mayo Clinic, Rochester, Minnesota
Trisha Suppes
Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, Texas
Paul E. Keck
Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati, Ohio, USA
Susan L. McElroy
Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati, Ohio, USA
Willem A. Nolen
Universitair Medisch Centrum Groningen (UMCG), Groningen
Ralph Kupka
H.C. Rumke Groep, Willem Arntsz Huis, Utrecht, The Netherlands
Heinz Grunze
Department of Psychiatry, University of Freiburg, Germany
Joerg Walden
Psychiatrische Clinik, Ludwig-Maximilians University, Munich, Germany
Robert M. Post, Bipolar Collaborative Network, 5415 W. Cedar Lane, Suite 201-B Bethesda, MD 20814, USA. Email:
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The relative incidence of childhood-onset bipolar illness in the USA compared with that in Europe is controversial. We examined this issue in more than 500 out-patients (average age 42 years) with bipolar illness who reported age at onset of first episode, family history, and childhood physical or sexual abuse. Childhood or adolescent onset of bipolar illness was reported by 61% of those in the US cohort but by only 30% of those in The Netherlands or Germany. In the USA there was also twice the incidence of childhood adversity and genetic/familial risk for affective disorder. The findings deserve replication and further exploration.

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Copyright © Royal College of Psychiatrists, 2008 


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