Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Subthreshold Pediatric BD Linked with Suicide Risk

Bipolar Disord; ePub 2018 Nov 27; Vaudreuil, et al

Subthreshold pediatric bipolar disorder (BD) is an identifiable morbid condition associated with significant functional impairment including psychiatric comorbidities and high rates of suicidality, according to a recent systematic review. Researchers included studies examining the morbidity of pediatric subthreshold BD. Extracted outcomes included functional impairment, severity of mood symptoms, psychiatric comorbidities, suicidal ideation and behaviors, and mental health treatment. 11 papers, consisting of 7 datasets, were included. Researchers compared subthreshold pediatric BD (n=244) to non‐bipolar controls (n=1,125) and subthreshold pediatric BD (n=643) to pediatric BD‐I (n=942). They found:

  • Subthreshold pediatric BD was associated with greater functional impairment, greater severity of mood symptomatology, higher rates of disruptive behavior, mood, and substance use disorders, and higher rates of suicidal ideation and attempts compared to controls.
  • Pediatric BD‐I was associated with greater functional impairment, greater severity of manic symptoms, higher rates of suicidal ideation and attempts, and higher rates of mental health treatment compared to subthreshold pediatric BD.
  • There were no differences between full and subthreshold cases in the severity of depressive symptoms or rates of comorbid disorders.

Vaudreuil CAH, Faraone SV, Di Salvo M, et al. The morbidity of subthreshold pediatric bipolar disorder: A systematic literature review and meta‐analysis. [Published online ahead of print November 27, 2018]. Bipolar Disord. doi:10.1111/bdi.12734.