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Robert L Findling - One of the best experts on this subject based on the ideXlab platform.
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longitudinal course and characteristics of Cyclothymic Disorder in youth
Journal of Affective Disorders, 2017Co-Authors: Anna Van Meter, Eric A Youngstrom, Boris Birmaher, Mary A Fristad, Sarah M Horwitz, Thomas W Frazier, Eugene L Arnold, Robert L FindlingAbstract:Abstract Objectives Epidemiological studies suggest that Cyclothymic Disorder is the most prevalent subtype of bipolar Disorder (BD). However, it is rarely diagnosed, especially in youth. This may be because it can be difficult to ascertain whether a youth meets diagnostic criteria. Clearer, easy-to-apply criteria could reduce misdiagnosis. The objective oftable this study was to determine whether proposed research diagnostic criteria for Cyclothymic Disorder (RDCyc), based on DSM-5 criteria, could be quantified and validated in youth. Methods Participants from the Longitudinal Assessment of Manic Symptoms (LAMS) study were recruited based on symptoms of mania and followed prospectively. RDCyc criteria were: 1) At least one core symptom each of mania and depression; 2) one additional symptom of mania and of depression; 3) persistence over two consecutive six-month periods, and 4) impairment. Exclusionary criteria were having a [hypo]manic or depressive episode. Outcomes at the two-year follow-up were compared between RDCyc youth and other diagnostic groups (BD I/II, BD NOS/non-RDCyc Cyclothymic Disorder, disruptive behavior Disorders [DBD], depression). Results Thirty-seven youth met RDCyc criteria. There were no consistent differences between the RDCyc youth and youth with other BD subtypes (ps=0.001–0.960, with all-but-one p value >0.02). RDCyc youth had higher depression (p Limitations The majority of youth in the sample were recruited due to elevated symptoms of mania, which may limit the generalizability of the results. Youth were followed for two years, which may not be long enough to determine whether or not they will eventually develop a manic or depressive episode. Conclusions Applying RDCyc criteria identified youth who were similar to others with BD and were more impaired than those with DBD. Using these criteria could reduce misdiagnosis and increase our understanding of this prevalent, but largely ignored, diagnosis.
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impact of irritability and impulsive aggressive behavior on impairment and social functioning in youth with Cyclothymic Disorder
Journal of Child and Adolescent Psychopharmacology, 2016Co-Authors: Anna Van Meter, Eric A Youngstrom, Jennifer Kogos Youngstrom, Norah C Feeny, Andrew J Freeman, Robert L FindlingAbstract:Abstract Objective: Research on adults with Cyclothymic Disorder (CycD) suggests that irritability and impulsive aggression (IA) are highly prevalent among this population. Less is known about whether these behaviors might also distinguish youth with CycD from youth without CycD. Additionally, little is known about how irritability and IA relate to one another, and whether they are associated with different outcomes. This study aimed to compare irritability and IA across diagnostic subtypes to determine whether CycD is uniquely associated with these behaviors, and to assess how irritability and IA relate to youth social and general functioning. Methods: Participants (n = 459), 11–18 years of age, were recruited from an urban community mental health center and an academic outpatient clinic; 25 had a diagnosis of CycD. Youth and caregivers completed measures of IA and irritability. Youth and caregivers also completed an assessment of youth friendship quality. Clinical interviewers assessed youth social, fam...
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Examining the Validity of Cyclothymic Disorder in a Youth Sample: Replication and Extension
Journal of Abnormal Child Psychology, 2013Co-Authors: Anna Van Meter, Eric A Youngstrom, Christine Demeter, Robert L FindlingAbstract:DSM-IV-TR defines four subtypes of bipolar Disorder (BP): bipolar I, bipolar II, Cyclothymic Disorder and bipolar not otherwise specified (NOS). However, Cyclothymic Disorder in children is rarely researched, or often subsumed in an “NOS” category. The present study tests the replicability of findings from an earlier study, and expands on the criterion validity of Cyclothymic Disorder in youth. Using the Robins and Guze ( 1970 ) framework we examined the validity of Cyclothymic Disorder as a subtype of BP. Using a youth (ages 5–17) outpatient clinical sample ( N = 894), participants with Cyclothymic Disorder ( n = 53) were compared to participants with other BP spectrum Disorders ( n = 399) and to participants with non-bipolar Disorders ( n = 442). Analyses tested differences in youth with Cyclothymic Disorder and bipolar Disorder not otherwise specified who do, and those who do not, have a parent with BP. Compared to youth with non-bipolar Disorders, youth with Cyclothymic Disorder had higher irritability ( p
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Cyclothymic Disorder a critical review
Clinical Psychology Review, 2012Co-Authors: Anna Van Meter, Eric A Youngstrom, Robert L FindlingAbstract:Abstract Cyclothymic Disorder is a subtype of bipolar Disorder included in the Diagnostic and Statistical Manual of Mental Disorders since 1980, but largely neglected in research. Additionally, it is rarely diagnosed clinically, in spite of evidence that it may be the most prevalent form of bipolar Disorder. Neglect has contributed to confusion about the diagnosis and clinical presentation of Cyclothymic Disorder. Its status as a mood Disorder is also ambiguous due to overlap in terminology and symptoms with temperament and personality Disorders. Subthreshold bipolar Disorder appears more prevalent among young people than previously thought, and follows a range of trajectories from remission to escalation—raising questions about risk factors and traits associated with the varied course. Cyclothymic Disorder may be an important diathesis for major mood Disorders. Constructs such as Cyclothymic Disorder link major mood Disorder and peri-clinical fluctuations of mood, thus warranting a prominent role in dimensional models of mood and psychopathology. Current evidence indicates that Cyclothymic Disorder is a prevalent and highly impairing Disorder on the bipolar spectrum, with the potential to make unique contributions to our understanding of the risk factors and outcomes associated with bipolar Disorder. The inclusion of Cyclothymic Disorder in future research studies is essential to accurate diagnosis and effective treatment for the full spectrum of bipolar Disorder, as well as understanding the developmental trajectory of bipolar spectrum Disorders.
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examining the validity of Cyclothymic Disorder in a youth sample replication and extension
International Clinical Psychopharmacology, 2011Co-Authors: Anna Van Meter, Eric A Youngstrom, Christine Demeter, Robert L FindlingAbstract:DSM-IV-TR defines four subtypes of bipolar Disorder (BP): bipolar I, bipolar II, Cyclothymic Disorder and bipolar not otherwise specified (NOS). However, Cyclothymic Disorder in children is rarely researched, or often subsumed in an "NOS" category. The present study tests the replicability of findings from an earlier study, and expands on the criterion validity of Cyclothymic Disorder in youth. Using the Robins and Guze (1970) framework we examined the validity of Cyclothymic Disorder as a subtype of BP. Using a youth (ages 5-17) outpatient clinical sample (N = 894), participants with Cyclothymic Disorder (n = 53) were compared to participants with other BP spectrum Disorders (n = 399) and to participants with non-bipolar Disorders (n = 442). Analyses tested differences in youth with Cyclothymic Disorder and bipolar Disorder not otherwise specified who do, and those who do not, have a parent with BP. Compared to youth with non-bipolar Disorders, youth with Cyclothymic Disorder had higher irritability (p < 0.001), more comorbidity (p < 0.001), greater sleep disturbance (p < 0.005), and were more likely to have a family history of BP (p < 0.001). Cyclothymic Disorder was associated with a younger age of onset compared to depression (p < 0.001) and bipolar II (p = 0.05). Parental BP status was not significantly associated with any variables. Results support that Cyclothymic Disorder belongs on the bipolar spectrum. Epidemiological studies indicate that Cyclothymic Disorder is not uncommon and involves significant impairment. Failing to differentiate between Cyclothymic Disorder and bipolar NOS limits our knowledge about a significant proportion of cases of bipolarity.
Anna Van Meter - One of the best experts on this subject based on the ideXlab platform.
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parsing Cyclothymic Disorder and other specified bipolar spectrum Disorders in youth
Journal of Affective Disorders, 2018Co-Authors: Anna Van Meter, Benjamin I Goldstein, Tina R Goldstein, Shirley Yen, Heather Hower, Michael Strober, John Merranko, Mary Kay Gill, Rasim Somer Diler, David AxelsonAbstract:Abstract Objective Most studies of pediatric bipolar Disorder (BP) combine youth who have manic symptoms, but do not meet criteria for BP I/II, into one “not otherwise specified” (NOS) group. Consequently, little is known about how youth with Cyclothymic Disorder (CycD) differ from youth with BP NOS. The objective of this study was to determine whether youth with a research diagnosis of CycD (RDCyc) differ from youth with operationalized BP NOS. Method Participants from the Course and Outcome of Bipolar Youth study were evaluated to determine whether they met RDCyc criteria. Characteristics of RDCyc youth and BP NOS youth were compared at baseline, and over eight-years follow-up. Results Of 154 youth (average age 11.96 (3.3), 42% female), 29 met RDCyc criteria. RDCyc youth were younger (p = .04) at baseline. Over follow-up, RDCyc youth were more likely to have a disruptive behavior Disorder (p = .01), and were more likely to experience irritability (p = .03), mood reactivity (p = .02), and rejection sensitivity (p = .03). BP NOS youth were more likely to develop hypomania (p = .02), or depression (p = .02), and tended to have mood episodes earlier in the eight-year follow-up period. Limitations RDCyc diagnoses were made retrospectively and followed stringent criteria, which may highlight differences that, under typical clinical conditions and more vague criteria, would not be evident. Conclusion There were few differences between RDCyc and BP NOS youth. However, the ways in which the groups diverged could have implications; chronic subsyndromal mood symptoms may portend a severe, but ultimately non-bipolar, course. Longer follow-up is necessary to determine the trajectory and outcomes of CycD symptoms.
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longitudinal course and characteristics of Cyclothymic Disorder in youth
Journal of Affective Disorders, 2017Co-Authors: Anna Van Meter, Eric A Youngstrom, Boris Birmaher, Mary A Fristad, Sarah M Horwitz, Thomas W Frazier, Eugene L Arnold, Robert L FindlingAbstract:Abstract Objectives Epidemiological studies suggest that Cyclothymic Disorder is the most prevalent subtype of bipolar Disorder (BD). However, it is rarely diagnosed, especially in youth. This may be because it can be difficult to ascertain whether a youth meets diagnostic criteria. Clearer, easy-to-apply criteria could reduce misdiagnosis. The objective oftable this study was to determine whether proposed research diagnostic criteria for Cyclothymic Disorder (RDCyc), based on DSM-5 criteria, could be quantified and validated in youth. Methods Participants from the Longitudinal Assessment of Manic Symptoms (LAMS) study were recruited based on symptoms of mania and followed prospectively. RDCyc criteria were: 1) At least one core symptom each of mania and depression; 2) one additional symptom of mania and of depression; 3) persistence over two consecutive six-month periods, and 4) impairment. Exclusionary criteria were having a [hypo]manic or depressive episode. Outcomes at the two-year follow-up were compared between RDCyc youth and other diagnostic groups (BD I/II, BD NOS/non-RDCyc Cyclothymic Disorder, disruptive behavior Disorders [DBD], depression). Results Thirty-seven youth met RDCyc criteria. There were no consistent differences between the RDCyc youth and youth with other BD subtypes (ps=0.001–0.960, with all-but-one p value >0.02). RDCyc youth had higher depression (p Limitations The majority of youth in the sample were recruited due to elevated symptoms of mania, which may limit the generalizability of the results. Youth were followed for two years, which may not be long enough to determine whether or not they will eventually develop a manic or depressive episode. Conclusions Applying RDCyc criteria identified youth who were similar to others with BD and were more impaired than those with DBD. Using these criteria could reduce misdiagnosis and increase our understanding of this prevalent, but largely ignored, diagnosis.
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impact of irritability and impulsive aggressive behavior on impairment and social functioning in youth with Cyclothymic Disorder
Journal of Child and Adolescent Psychopharmacology, 2016Co-Authors: Anna Van Meter, Eric A Youngstrom, Jennifer Kogos Youngstrom, Norah C Feeny, Andrew J Freeman, Robert L FindlingAbstract:Abstract Objective: Research on adults with Cyclothymic Disorder (CycD) suggests that irritability and impulsive aggression (IA) are highly prevalent among this population. Less is known about whether these behaviors might also distinguish youth with CycD from youth without CycD. Additionally, little is known about how irritability and IA relate to one another, and whether they are associated with different outcomes. This study aimed to compare irritability and IA across diagnostic subtypes to determine whether CycD is uniquely associated with these behaviors, and to assess how irritability and IA relate to youth social and general functioning. Methods: Participants (n = 459), 11–18 years of age, were recruited from an urban community mental health center and an academic outpatient clinic; 25 had a diagnosis of CycD. Youth and caregivers completed measures of IA and irritability. Youth and caregivers also completed an assessment of youth friendship quality. Clinical interviewers assessed youth social, fam...
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Examining the Validity of Cyclothymic Disorder in a Youth Sample: Replication and Extension
Journal of Abnormal Child Psychology, 2013Co-Authors: Anna Van Meter, Eric A Youngstrom, Christine Demeter, Robert L FindlingAbstract:DSM-IV-TR defines four subtypes of bipolar Disorder (BP): bipolar I, bipolar II, Cyclothymic Disorder and bipolar not otherwise specified (NOS). However, Cyclothymic Disorder in children is rarely researched, or often subsumed in an “NOS” category. The present study tests the replicability of findings from an earlier study, and expands on the criterion validity of Cyclothymic Disorder in youth. Using the Robins and Guze ( 1970 ) framework we examined the validity of Cyclothymic Disorder as a subtype of BP. Using a youth (ages 5–17) outpatient clinical sample ( N = 894), participants with Cyclothymic Disorder ( n = 53) were compared to participants with other BP spectrum Disorders ( n = 399) and to participants with non-bipolar Disorders ( n = 442). Analyses tested differences in youth with Cyclothymic Disorder and bipolar Disorder not otherwise specified who do, and those who do not, have a parent with BP. Compared to youth with non-bipolar Disorders, youth with Cyclothymic Disorder had higher irritability ( p
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Cyclothymic Disorder in youth why is it overlooked what do we know and where is the field headed
Neuropsychiatry, 2012Co-Authors: Anna Van Meter, Eric A YoungstromAbstract:Cyclothymic Disorder is a chronic and impairing subtype of bipolar Disorder, largely neglected in pediatric research. Consequently, it is rarely diagnosed clinically despite potentially being the most prevalent form of bipolar Disorder. Lack of attention has added to confusion about the diagnosis and clinical presentation of Cyclothymic Disorder. In pediatric studies, Cyclothymic Disorder is commonly grouped with ‘subthreshold’ presentations of bipolar Disorder under the undifferentiated label ‘bipolar Disorder not otherwise specified’. However, research indicates that Cyclothymic Disorder can be reliably distinguished from the other forms of bipolar Disorder and from other childhood Disorders. Importantly, Cyclothymic Disorder may be a diathesis for more acute presentations of bipolar Disorder, warranting a prominent role in dimensional models of mood and psychopathology. Current evidence suggests that Cyclothymic Disorder has the potential to make unique contributions to our understanding of the risk factors and outcomes associated with bipolar Disorder. This potential has yet to be fully realized, limiting our knowledge and ability to intervene in a meaningful way with youth who are exhibiting symptoms of a major mood Disorder. Including Cyclothymic Disorder in future research studies of children – particularly longitudinal outcome studies – is essential for understanding the developmental trajectory of bipolar spectrum Disorders and learning how to accurately diagnosis and treat the full spectrum of bipolar Disorders.
Eric A Youngstrom - One of the best experts on this subject based on the ideXlab platform.
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longitudinal course and characteristics of Cyclothymic Disorder in youth
Journal of Affective Disorders, 2017Co-Authors: Anna Van Meter, Eric A Youngstrom, Boris Birmaher, Mary A Fristad, Sarah M Horwitz, Thomas W Frazier, Eugene L Arnold, Robert L FindlingAbstract:Abstract Objectives Epidemiological studies suggest that Cyclothymic Disorder is the most prevalent subtype of bipolar Disorder (BD). However, it is rarely diagnosed, especially in youth. This may be because it can be difficult to ascertain whether a youth meets diagnostic criteria. Clearer, easy-to-apply criteria could reduce misdiagnosis. The objective oftable this study was to determine whether proposed research diagnostic criteria for Cyclothymic Disorder (RDCyc), based on DSM-5 criteria, could be quantified and validated in youth. Methods Participants from the Longitudinal Assessment of Manic Symptoms (LAMS) study were recruited based on symptoms of mania and followed prospectively. RDCyc criteria were: 1) At least one core symptom each of mania and depression; 2) one additional symptom of mania and of depression; 3) persistence over two consecutive six-month periods, and 4) impairment. Exclusionary criteria were having a [hypo]manic or depressive episode. Outcomes at the two-year follow-up were compared between RDCyc youth and other diagnostic groups (BD I/II, BD NOS/non-RDCyc Cyclothymic Disorder, disruptive behavior Disorders [DBD], depression). Results Thirty-seven youth met RDCyc criteria. There were no consistent differences between the RDCyc youth and youth with other BD subtypes (ps=0.001–0.960, with all-but-one p value >0.02). RDCyc youth had higher depression (p Limitations The majority of youth in the sample were recruited due to elevated symptoms of mania, which may limit the generalizability of the results. Youth were followed for two years, which may not be long enough to determine whether or not they will eventually develop a manic or depressive episode. Conclusions Applying RDCyc criteria identified youth who were similar to others with BD and were more impaired than those with DBD. Using these criteria could reduce misdiagnosis and increase our understanding of this prevalent, but largely ignored, diagnosis.
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impact of irritability and impulsive aggressive behavior on impairment and social functioning in youth with Cyclothymic Disorder
Journal of Child and Adolescent Psychopharmacology, 2016Co-Authors: Anna Van Meter, Eric A Youngstrom, Jennifer Kogos Youngstrom, Norah C Feeny, Andrew J Freeman, Robert L FindlingAbstract:Abstract Objective: Research on adults with Cyclothymic Disorder (CycD) suggests that irritability and impulsive aggression (IA) are highly prevalent among this population. Less is known about whether these behaviors might also distinguish youth with CycD from youth without CycD. Additionally, little is known about how irritability and IA relate to one another, and whether they are associated with different outcomes. This study aimed to compare irritability and IA across diagnostic subtypes to determine whether CycD is uniquely associated with these behaviors, and to assess how irritability and IA relate to youth social and general functioning. Methods: Participants (n = 459), 11–18 years of age, were recruited from an urban community mental health center and an academic outpatient clinic; 25 had a diagnosis of CycD. Youth and caregivers completed measures of IA and irritability. Youth and caregivers also completed an assessment of youth friendship quality. Clinical interviewers assessed youth social, fam...
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Examining the Validity of Cyclothymic Disorder in a Youth Sample: Replication and Extension
Journal of Abnormal Child Psychology, 2013Co-Authors: Anna Van Meter, Eric A Youngstrom, Christine Demeter, Robert L FindlingAbstract:DSM-IV-TR defines four subtypes of bipolar Disorder (BP): bipolar I, bipolar II, Cyclothymic Disorder and bipolar not otherwise specified (NOS). However, Cyclothymic Disorder in children is rarely researched, or often subsumed in an “NOS” category. The present study tests the replicability of findings from an earlier study, and expands on the criterion validity of Cyclothymic Disorder in youth. Using the Robins and Guze ( 1970 ) framework we examined the validity of Cyclothymic Disorder as a subtype of BP. Using a youth (ages 5–17) outpatient clinical sample ( N = 894), participants with Cyclothymic Disorder ( n = 53) were compared to participants with other BP spectrum Disorders ( n = 399) and to participants with non-bipolar Disorders ( n = 442). Analyses tested differences in youth with Cyclothymic Disorder and bipolar Disorder not otherwise specified who do, and those who do not, have a parent with BP. Compared to youth with non-bipolar Disorders, youth with Cyclothymic Disorder had higher irritability ( p
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Cyclothymic Disorder in youth why is it overlooked what do we know and where is the field headed
Neuropsychiatry, 2012Co-Authors: Anna Van Meter, Eric A YoungstromAbstract:Cyclothymic Disorder is a chronic and impairing subtype of bipolar Disorder, largely neglected in pediatric research. Consequently, it is rarely diagnosed clinically despite potentially being the most prevalent form of bipolar Disorder. Lack of attention has added to confusion about the diagnosis and clinical presentation of Cyclothymic Disorder. In pediatric studies, Cyclothymic Disorder is commonly grouped with ‘subthreshold’ presentations of bipolar Disorder under the undifferentiated label ‘bipolar Disorder not otherwise specified’. However, research indicates that Cyclothymic Disorder can be reliably distinguished from the other forms of bipolar Disorder and from other childhood Disorders. Importantly, Cyclothymic Disorder may be a diathesis for more acute presentations of bipolar Disorder, warranting a prominent role in dimensional models of mood and psychopathology. Current evidence suggests that Cyclothymic Disorder has the potential to make unique contributions to our understanding of the risk factors and outcomes associated with bipolar Disorder. This potential has yet to be fully realized, limiting our knowledge and ability to intervene in a meaningful way with youth who are exhibiting symptoms of a major mood Disorder. Including Cyclothymic Disorder in future research studies of children – particularly longitudinal outcome studies – is essential for understanding the developmental trajectory of bipolar spectrum Disorders and learning how to accurately diagnosis and treat the full spectrum of bipolar Disorders.
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Cyclothymic Disorder a critical review
Clinical Psychology Review, 2012Co-Authors: Anna Van Meter, Eric A Youngstrom, Robert L FindlingAbstract:Abstract Cyclothymic Disorder is a subtype of bipolar Disorder included in the Diagnostic and Statistical Manual of Mental Disorders since 1980, but largely neglected in research. Additionally, it is rarely diagnosed clinically, in spite of evidence that it may be the most prevalent form of bipolar Disorder. Neglect has contributed to confusion about the diagnosis and clinical presentation of Cyclothymic Disorder. Its status as a mood Disorder is also ambiguous due to overlap in terminology and symptoms with temperament and personality Disorders. Subthreshold bipolar Disorder appears more prevalent among young people than previously thought, and follows a range of trajectories from remission to escalation—raising questions about risk factors and traits associated with the varied course. Cyclothymic Disorder may be an important diathesis for major mood Disorders. Constructs such as Cyclothymic Disorder link major mood Disorder and peri-clinical fluctuations of mood, thus warranting a prominent role in dimensional models of mood and psychopathology. Current evidence indicates that Cyclothymic Disorder is a prevalent and highly impairing Disorder on the bipolar spectrum, with the potential to make unique contributions to our understanding of the risk factors and outcomes associated with bipolar Disorder. The inclusion of Cyclothymic Disorder in future research studies is essential to accurate diagnosis and effective treatment for the full spectrum of bipolar Disorder, as well as understanding the developmental trajectory of bipolar spectrum Disorders.
Jennifer Kogos Youngstrom - One of the best experts on this subject based on the ideXlab platform.
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impact of irritability and impulsive aggressive behavior on impairment and social functioning in youth with Cyclothymic Disorder
Journal of Child and Adolescent Psychopharmacology, 2016Co-Authors: Anna Van Meter, Eric A Youngstrom, Jennifer Kogos Youngstrom, Norah C Feeny, Andrew J Freeman, Robert L FindlingAbstract:Abstract Objective: Research on adults with Cyclothymic Disorder (CycD) suggests that irritability and impulsive aggression (IA) are highly prevalent among this population. Less is known about whether these behaviors might also distinguish youth with CycD from youth without CycD. Additionally, little is known about how irritability and IA relate to one another, and whether they are associated with different outcomes. This study aimed to compare irritability and IA across diagnostic subtypes to determine whether CycD is uniquely associated with these behaviors, and to assess how irritability and IA relate to youth social and general functioning. Methods: Participants (n = 459), 11–18 years of age, were recruited from an urban community mental health center and an academic outpatient clinic; 25 had a diagnosis of CycD. Youth and caregivers completed measures of IA and irritability. Youth and caregivers also completed an assessment of youth friendship quality. Clinical interviewers assessed youth social, fam...
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Examining the validity of Cyclothymic Disorder in a youth sample.
Journal of affective disorders, 2011Co-Authors: Anna Van Meter, Eric A Youngstrom, Jennifer Kogos Youngstrom, Norah C Feeny, Robert L FindlingAbstract:Four subtypes of bipolar Disorder (BP) - bipolar I, bipolar II, cyclothymia and bipolar not otherwise specified (NOS) - are defined in DSM-IV-TR. Though the diagnostic criteria for each subtype are intended for both adults and children, research investigators and clinicians often stray from the DSM when diagnosing pediatric bipolar Disorder (PBD) (Youngstrom, 2009), resulting in a lack of agreement and understanding regarding the PBD subtypes. The present study uses the diagnostic validation method first proposed by Robins and Guze (1970) to systematically evaluate Cyclothymic Disorder as a distinct diagnostic subtype of BP. Using a youth (ages 5-17) outpatient clinical sample (n=827), participants with Cyclothymic Disorder (n=52) were compared to participants with other BP spectrum Disorders and to participants with non-bipolar Disorders. Results indicate that Cyclothymic Disorder shares many characteristics with other bipolar subtypes, supporting its inclusion on the bipolar spectrum. Additionally, cyclothymia could be reliably differentiated from non-mood Disorders based on irritability, sleep disturbance, age of symptom onset, comorbid diagnoses, and family history. There is little supporting research on cyclothymia in young people; these analyses may be considered exploratory. Gaps in this and other studies are highlighted as areas in need of additional research. Cyclothymic Disorder has serious implications for those affected. Though it is rarely diagnosed currently, it can be reliably differentiated from other Disorders in young people. Failing to accurately diagnose cyclothymia, and other subthreshold forms of bipolar Disorder, contributes to a significant delay in appropriate treatment and may have serious prognostic implications. Copyright © 2011 Elsevier B.V. All rights reserved.
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Examining the validity of Cyclothymic Disorder in a youth sample
Journal of Affective Disorders, 2011Co-Authors: Anna Van Meter, Eric A Youngstrom, Jennifer Kogos Youngstrom, Norah C Feeny, Robert L FindlingAbstract:Background Four subtypes of bipolar Disorder (BP) – bipolar I, bipolar II, cyclothymia and bipolar not otherwise specified (NOS) – are defined in DSM-IV-TR. Though the diagnostic criteria for each subtype are intended for both adults and children, research investigators and clinicians often stray from the DSM when diagnosing pediatric bipolar Disorder (PBD) (Youngstrom, 2009), resulting in a lack of agreement and understanding regarding the PBD subtypes.
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suicidality in pediatric bipolar Disorder predictor or outcome of family processes and mixed mood presentation
Bipolar Disorders, 2011Co-Authors: Guillermo Perez Algorta, Eric A Youngstrom, Jennifer Kogos Youngstrom, Thomas W Frazier, Andrew J Freeman, Robert L FindlingAbstract:Objective: Pediatric bipolar Disorder (PBD) involves a potent combination of mood dysregulation and interpersonal processes, placing these youth at significantly greater risk of suicide. We examined the relationship between suicidal behavior, mood symptom presentation, family functioning, and quality of life (QoL) in youth with PBD. Methods: Participants were 138 youths aged 5-18 years presenting to outpatient clinics with DSM-IV diagnoses of bipolar I Disorder (n = 27), bipolar II Disorder (n = 18), Cyclothymic Disorder (n = 48), and bipolar Disorder not otherwise specified (n = 45). Results: Twenty PBD patients had lifetime suicide attempts, 63 had past or current suicide ideation, and 55 were free of suicide ideation and attempts. Attempters were older than nonattempters. Suicide ideation and attempts were linked to higher depressive symptoms, and rates were even higher in youths meeting criteria for the mixed specifier proposed for DSM-5. Both suicide ideation and attempts were associated with lower youth QoL and poorer family functioning. Parent effects (with suicidality treated as outcome) and child effects (where suicide was the predictor of poor family functioning) showed equally strong evidence in regression models, even after adjusting for demographics. Conclusions: These findings underscore the strong association between mixed features and suicidality in PBD, as well as the association between QoL, family functioning, and suicidality. It is possible that youths are not just a passive recipient of family processes, and their illness may play an active role in disrupting family functioning. Replication with longitudinal data and qualitative methods should investigate both child and parent effect models. Language: en
Mary A Fristad - One of the best experts on this subject based on the ideXlab platform.
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omega 3 supplementation associated with improved parent rated executive function in youth with mood Disorders secondary analyses of the omega 3 and therapy oats trials
Journal of Child Psychology and Psychiatry, 2018Co-Authors: Anthony T Vesco, Eugene L Arnold, Andrea S Young, Mary A FristadAbstract:Background Improvements in executive functioning (EF) may lead to improved quality of life and lessened functional impairment for children with mood Disorders. The aim was to assess the impact of omega-3 supplementation (Ω3) and psychoeducational psychotherapy (PEP), each alone and in combination, on EF in youth with mood Disorders. We completed secondary analyses of two randomized controlled trials (RCTs) of Ω3 and PEP for children with depression and bipolar Disorder. Methods Ninety-five youths with depression or bipolar Disorder not otherwise specified/Cyclothymic Disorder were randomized in 12-week RCTs. Two capsules (Ω3 or placebo) were given twice daily (1.87 g Ω3 total daily, mostly eicosapentaenoic acid). Families randomized to PEP participated in twice-weekly 50-min sessions. Analyses assess impact of interventions on the Behavior Rating Inventory of Executive Functioning (BRIEF) parent-report Global Executive Composite (GEC) and two subscales, Behavior Regulation (BRI) and Metacognition (MI) Indices. Intent-to-treat repeated measures ANOVAs, using multiple imputation for missing data, included all 95 randomized participants. Trials were registered with www.clinicaltrials.gov, NCT01341925 & NCT01507753. Results Participants receiving Ω3 (aggregating combined and monotherapy) improved significantly more than aggregated placebo on GEC (p = .001, d = .70), BRI (p = .004, d = .49), and MI (p = .04, d = .41). Ω3 alone (d = .49) and combined with PEP (d = .67) each surpassed placebo on GEC. Moderation by attention-deficit/hyperactivity Disorder (ADHD) comorbidity was nonsignificant although those with ADHD showed nominally greater gains. PEP monotherapy had negligible effect. Conclusions Decreased impairment in EF was associated with Ω3 supplementation in youth with mood Disorders. Research examining causal associations of Ω3, EF, and mood symptoms is warranted.
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longitudinal course and characteristics of Cyclothymic Disorder in youth
Journal of Affective Disorders, 2017Co-Authors: Anna Van Meter, Eric A Youngstrom, Boris Birmaher, Mary A Fristad, Sarah M Horwitz, Thomas W Frazier, Eugene L Arnold, Robert L FindlingAbstract:Abstract Objectives Epidemiological studies suggest that Cyclothymic Disorder is the most prevalent subtype of bipolar Disorder (BD). However, it is rarely diagnosed, especially in youth. This may be because it can be difficult to ascertain whether a youth meets diagnostic criteria. Clearer, easy-to-apply criteria could reduce misdiagnosis. The objective oftable this study was to determine whether proposed research diagnostic criteria for Cyclothymic Disorder (RDCyc), based on DSM-5 criteria, could be quantified and validated in youth. Methods Participants from the Longitudinal Assessment of Manic Symptoms (LAMS) study were recruited based on symptoms of mania and followed prospectively. RDCyc criteria were: 1) At least one core symptom each of mania and depression; 2) one additional symptom of mania and of depression; 3) persistence over two consecutive six-month periods, and 4) impairment. Exclusionary criteria were having a [hypo]manic or depressive episode. Outcomes at the two-year follow-up were compared between RDCyc youth and other diagnostic groups (BD I/II, BD NOS/non-RDCyc Cyclothymic Disorder, disruptive behavior Disorders [DBD], depression). Results Thirty-seven youth met RDCyc criteria. There were no consistent differences between the RDCyc youth and youth with other BD subtypes (ps=0.001–0.960, with all-but-one p value >0.02). RDCyc youth had higher depression (p Limitations The majority of youth in the sample were recruited due to elevated symptoms of mania, which may limit the generalizability of the results. Youth were followed for two years, which may not be long enough to determine whether or not they will eventually develop a manic or depressive episode. Conclusions Applying RDCyc criteria identified youth who were similar to others with BD and were more impaired than those with DBD. Using these criteria could reduce misdiagnosis and increase our understanding of this prevalent, but largely ignored, diagnosis.
