Table 1:
Child studies
| Author | Original Sample | Diagnostic criteria / Semi-structured Interview used | Recurrence definition | Recurrence assessment | Factor assessed | Risk or Protective factor | Factor assessment | Prospective or cross-sectional | Case control or cohort |
|---|---|---|---|---|---|---|---|---|---|
| Yen et al., 2016 | COBY | DSM-IV / KSADS-PL | Depressive or manic episode, was defined as having followed a period of recovery, and as having again met full diagnostic criteria (PSR score of 5 or 6) for a minimum duration of 1 week for mania and 2 weeks for depression. | A-LIFE; PSR | Comorbidity (Anxiety, ADHD, Disruptive Behavior Disorders, Substance Abuse) | Risk | KSADS-PL | Prospective | Case-control |
| Hirneth et al., 2015 (91) | The Bipolar Program | DSM-IV-TR / WASH-U-KSADS | Episodes were defined as a period of active symptoms ( ≥ 4 or ‘moderate’ on WASH-U-KSADS items; ≥ 3 or ‘mild’ for hypomania) demarcated at each end by a period of nil or minimal mood and behavioral symptoms consistent with the person’s baseline level of functioning; that is, ratings of 1 (nil) or 2 (slight) on WASH-U-KSADS. items. |
WASH-U-KSADS | Bipolar subtype I (vs. II and NOS) | Risk | WASH-U-KSADS | Cross-sectional | Cohort |
| Birmaher et al., 2014 | Age at onset (higher) | Protective | KSADS-PL | ||||||
| Lifetime family history of bipolar and substance use disorders (less) | Protective | FHS | |||||||
| History at baseline of severe depression or manic or hypomanic symptoms (less) | Protective | KSADS-PL | |||||||
| KSADS M | |||||||||
| COBY | DSM-IV / KSADS-PL | A recurrence (new episode) required a PSR ≥5, with duration of 1-week for mania/hypomania and 2-weeks for depression. | A-LIFE; PSR | KSADS D | Prospective | Case-control | |||
| Protective | KSADS-PL | ||||||||
| Subsyndromal episodes (fewer) | KSADS M | ||||||||
| KSADS D | |||||||||
| Sexual abuse (less) | Protective | CBQ | |||||||
| FACES-II | |||||||||
| Socioeconomic status (higher) | Protective | HS | |||||||
| Sala et al., 2014 | COBY | DSM-IV / KSADS-PL | A recurrence (new episode) required a PSR ≥5, with duration of 1-week for mania/hypomania and 2-weeks for depression. | A-LIFE; PSR | Comorbidity (anxiety) | Risk | KSADS-PL | Prospective | Cohort |
| Wozniak et al., 2013 | Massachusetts | DSM-IV / KSADS-E | To gauge a distinct episode, our interviewers asked for ‘a distinct period (of at least 1 week) of extreme and persistently elevated, expansive or irritable mood’ and further required that the irritability endorsed in this module is ‘super’ and ‘extreme.’ | KSADS-E | Sex (male) | Risk | KSADS-E | Cross-sectional | Cohort |
| Sala et al., 2012 | COBY | DSM-IV / KSADS-PL | A recurrence (new episode) required a PSR ≥5, with duration of 1-week for mania/hypomania and 2-weeks for depression. | A-LIFE; PSR | Comorbidity (anxiety) | Risk | KSADS-PL | Prospective | Cohort |
| Hua et al., 2011 | Massachusetts | DSM-IV/ KSADS-E | Lifetime BPD episodes were classified as the number of distinct and separate BPD episodes that met either full or subthreshold DSM-IV criteria for Mania. | KSADS-E | Comorbidity (psychosis) | Risk | KSADS-E | Cross-sectional | Cohort |
| Ratheesh et al., 2011 | NIMHANS | DSM-IV / KSADS-PL | Not defined | KSADS-PL | Comorbidity (anxiety) | Risk | KSADS-PL | Cross-sectional | Cohort |
| Wozniak et al., 2011 | Massachusetts | DSM-IV / KSADS-E | To gauge a distinct episode our interviewers asked for a distinct period (of at least one week) of extreme and persistently elevated, expansive or irritable mood and further required that the irritability endorsed in this module was ‘super’ and ‘extreme.’ To meet for a subthreshold diagnosis of mania, a child must have met criterion A for a period of four days or longer, and/or have at least two (three if the mood is irritable only) of the seven criterion B symptoms, and associated impairment. | KSADS-E; SCID |
Symptomatic group (vs. subsyndromal) |
Risk | KSADS-E/ SCID | Prospective | Cohort |
| Birmaher et al., 2009 | COBY | DSM-IV / KSADS-PL | A recurrence (new episode) required a PSR ≥ 5, with duration of 1-week for mania/hypomania and 2-weeks for depression. | A-LIFE; PSR | Bipolar subtype I and II (vs. NOS) | Risk | KSADS-PL | Prospective | Cohort |
| Geller et al., 2008 | PCPBD | DSM-IV / WASH-U- KSADS | Relapse after recovery was defined as 2 consecutive weeks of meeting DSM-IV criteria for mania with a CGAS score of 60 or lower, indicating significant clinical impairment. | WASH-U-KSADS | Maternal warmth (low) | Risk | PSSAC-R | Prospective | Cohort |
| DelBello et al., 2007 | DSM-IV / WASH-U- KSADS | Syndromic recurrence was defined by 1 week (2 weeks for depression) with a LIFE overall score of ≥5 anytime after syndromic recovery. Time to each type of recovery included the 8 consecutive weeks that the patient met criteria for that type of recovery. | YMRS; HAM-D; SAPS | Risk | WASH-U-KSADS | Prospective | Cohort | ||
| CCHMC | Comorbidity (alcohol use disorder) | ||||||||
| Birmaher et al., 2006 | A recurrence (new episode) required a PSR score of 5 or more, with durations of 1 week for mania/hypomania and 2 weeks for depression. | Bipolar subtype I | Risk | KSADS-PL | Prospective | Cohort | |||
| (vs. II and NOS) | |||||||||
| COBY | DSM-IV / KSADS-PL | A-LIFE; PSR | Socioeconomic status (lower) | Risk | HS | ||||
| Comorbidity (psychosis) | Risk | KSADS-PL | |||||||
| Sex (female) | Risk | KSADS-PL | |||||||
| Wals et al., 2005 | Netherlands offspring | DSM-IV / KSADS-PL | Not defined | KSADS-PL | Stressful life events | Risk Not Found | LEDS | Prospective | Cohort |
| Jairam et al., 2004 | NIMHANS | DSM-III-R / DICA-R | Relapse is defined as a new affective episode satisfying DSM-IV criteria for the disorder occurring after the period of recovery or without any intervening period of recovery if there was a clear change in polarity along with a clinically significant impairment with the CGAS score < 60. | MAGIC |
Depressive episodes CGAS follow-up (lower) |
Risk Risk |
DICA-R CGAS |
Prospective | Case-control |
| YMRS | Prior episodes | Risk Not Found | DICA-R | ||||||
| GAS | First episode polarity | Risk Not Found | DICA-R | ||||||
| Sex | Risk Not Found | DICA-R | |||||||
| Age at onset | Risk Not Found | DICA-R | |||||||
| Comorbidity (psychosis included) | Risk Not Found | DICA-R | |||||||
| Subsyndromal symptoms | Risk Not Found | DICA-R | |||||||
| Lifetime family history of affective illness | Risk Not Found | DICA-R | |||||||
| Lewinsohn et al., 2000 (92) | Western Oregon | DSM-IIIR / KSADS | Not defined | LIFE | Syndromal group | Risk | KSADS | Prospective | Cohort |
| (vs. Bipolar subtype NOS) | |||||||||
| Srinath et al., 1998 | NIMHANS | DSM-IIIR / ISCA | Relapse was defined as a new episode of illness satisfying DSM-IIIR criteria for the disorder. | FISA | Age at onset | Risk Not Found | ISCA; ISAAC | Prospective | Cohort |
| ISCA | Sex | Risk Not Found | ISCA; ISAAC | ||||||
| Other resources | Prior episodes | Risk Not Found | ISCA; ISAAC | ||||||
| First episode polarity | Risk Not Found | ISCA; ISAAC | |||||||
| Comorbidity (psychosis) | Risk Not Found | ISCA; ISAAC | |||||||
| Lifetime family history of affective and psychotic illness | Risk Not Found | FH-RDC | |||||||
| Kovacs et al., 1995 | University of Pittsburgh | DSM-III / ISCA | If the subject recovered from an episode, but upon follow-up was found to have become symptomatic again in 2 months or less of the tentative “offset” date, he or she was designated as still in the previous episode of the illness. | ISCA | Comorbidity (conduct disorder) | Risk Not Found | ISCA | Prospective | Cohort |
| Strober et al., 1995 | UCLA | DSM-III / KSADS | Relapse was defined as a new episode of illness satisfying RDC for mania or major depression. | Sex | Risk Not Found | KSADS | Prospective | Cohort | |
| Comorbidity (psychosis) | Risk Not Found | KSADS | |||||||
| LIFE | Lifetime family history of bipolar illness | Risk Not Found | KSADS | ||||||
| Prior episodes | Risk Not Found | KSADS | |||||||
| Polarity episode intake | Risk Not Found | KSADS | |||||||
| Bashir et al., 1987 | Rivendell | DSM-III / no interview | Not defined | Check-Lists | Age at onset | Risk Not Found | Clinical interview | Prospective | Cohort |
NOQAS: Newcastle-Ottawa Quality Assessment Scale; COBY: Course and Outcome of Bipolar Youth; DSM: Diagnostic and Statistical Manual of Mental Disorders; KSADS-PL: Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime version; PSR: Psychiatric Status Rating; A-LIFE: Adolescent-Longitudinal Interval Follow-up Evaluation; ADHD: attention deficit hyperactivity disorder; WASH-U-KSADS: Washington University at St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia version; Bipolar subtype NOS: Bipolar subtype no otherwise specified; FHS: Family History Screen; KSADS M: Kiddie Mania Rating Scale; KSADS D: Kiddie Depression Rating Scale; CBQ: Conflict Behavior Questionnaire; FACES-II: Family Adaptation and Cohesion Scale-II; HS: Hollingshead 4-Factor Scale; KSADS-E: Kiddie Schedule for Affective Disorders and Schizophrenia Epidemiological version; BPD: Bipolar Disorder; NIMHANS: National Institute of Mental Health and Neurosciences; SCID: Structured Clinical Interview for DSM; PCPBD: Phenomenology and Course of Pediatric Bipolar Disorders; CGAS: Children’s Global Assessment Scale; PSSAC-R: Psychosocial Schedule for School-Age Children-Revised; CCHMC: Cincinnati Children’s Hospital Medical Center; YMRS: Young Maria Rating Scale; HAM-D: Hamilton Depression rating Scale; SAPS: Scale for the Assessment of Positive Symptoms; LEDS: The Bedfort College Life Event and Difficulties Schedule; DICA-R: Diagnostic Interview for Children and Adolescents-Revised; MAGIC: Missouri Assessment for Genetic Interview in Children; GAS: Global Assessment Scale; LIFE: Longitudinal Interval Follow-up Evaluation; ISCA: Interview Schedule for Children and Adolescents; FISA: Follow-up Interview Schedule for Young Adults; ISAAC: Intake Sheet for Adolescents: Cross-Cultural Study; FH-RDC: Family History-Research Diagnostic Criteria; UCLA: University of California, Los Angeles; RDC: Research Diagnostic Criteria.