Mania in Adolescence: The Role of Childhood Trauma and Neurodevelopmental Disorders in a Swedish Population-Based Study
27 Pages Posted: 29 Jul 2019More...
Background: Childhood traumatic experiences (CTEs) and neurodevelopmental disorders (NDDs) are childhood risk factors that have both been linked, separately, to mania. Mania symptoms in adolescence are a precursor of bipolar disorder. We investigate whether children with CTEs and NDDs are at a greater risk of developing mania in adolescence.
Methods: In a population-representative Swedish twin study, CTEs and NDDs were assessed at age 9 in 3,348 nine-year old twins born between 1998 and 2001. Follow-up data was gathered at age 15 through parental reports of mania symptoms.
Findings: Both CTEs and NDDs at age 9 contributed significantly to an increase in mania symptoms at age 15 (CTEs: Incidence Rate Ratio [IRR]: 1.26, 95% CI 1.06-1.50, p = .0083; NDDs: IRR: 1.63, 95% CI 1.37-1.93, p < .0001). Children with both risk factors were at twice the risk of developing mania than those with no exposure (IRR: 2.05, 95% CI 1.65-2.55, P <0.0001). NDDs showed a trend towards having a larger effect on mania symptoms than CTEs (IRR: 1.29, 95% CI 0.99-1.68, p = 0.06).
Interpretation: NDDs are at least as important as CTEs in the development of mania in adolescence. Exposure to both CTEs and NDDs greatly increases mania symptom load in adolescence as compared to having one risk factor only. Children with both CTEs and NDDs should be monitored closely for the development of mania in adolescence.
Funding Statement: This study received no specific funding.
Declaration of Interests: The authors have declared that they have no competing or potential conflicts of interest.
Ethics Approval Statement: The CATSS has ethical approval from the Regional Ethical Review Board in Stockholm. Oral consent has been obtained from all subjects participating in the telephone interview.
Keywords: Neurodevelopmental disorders, Childhood traumatic experiences, Mania, Bipolar disorder
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