Association between externalized disorders and age of onset in patients with bipolar disorder type I and II. Are the externalized disorders symptoms predictors of an earlier onset?

Abstract

BackgroundEarly onset mania (MIMT), compared with adolescent onset mania (MIA),has a different clinical presentation of classic mania adult onset(MIEA). Patients with MIA have a course more like the MIEA.Externalizing disorders (ADHD, ODD, and TC) have been associated with anearlier age of onset of bipolar disorder and as a marker of poorprognosis. Our goal is to determine the frequency of symptoms related todisruptive behavior disorders in patients with bipolar disorder startvery early, early and adult evaluated retrospectively.MethodsThe total sample (N=64) of adolescent and adult patients was obtainedfrom the National Institute of Psychiatry (INPRF) clinics. The diagnosiswas confirmed by the research team. Patients signed the informedasentment and consentment. We applied the K SADS PL Mexico, MINI andMINI KID. We used the EEPE-AA for externalizing disorders.ResultsThere were significant differences in scores compared by EEPE AA EIEDgroups in the Inattention subscale for GIMT. The presence of ADHD, ODD,TC and Suicide Risk in the time of evaluation was significantlyassociated with an earlier onset.Discussion and conclusionOur data supports the clinical utility and importance of separating theTBP by age of onset. The detection of externalizing disorders may speakof an early onset of the disorder and may also have implications forprognosis and psychopharmacological treatment, since the TBP-onsetchildhood to adulthood remains similar and difficult to manage. Thissuggests that we must have a longitudinal view of this disorder.