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Clinical Course of Children with a Depressive Spectrum Disorder and Transient Manic Symptoms

Nadkarni-DeAngelis, Radha Bhaskar
http://rave.ohiolink.edu/etdc/view?acc_num=osu1242225627

Abstract Details

2009, Doctor of Philosophy, Ohio State University, Psychology.
The present study (Multi-family Psychoeducation Group) provides 18-month longitudinal follow-up of children diagnosed with depressive spectrum disorder (DSD; major depressive disorder and/or dysthymic disorder) who present with clearly demarcated transient manic symptoms (TMS) of insufficient number or duration to be diagnosed with a bipolar spectrum disorder (BPSD; Bipolar-I, Bipolar-II, Cyclothymia, Bipolar-Not Otherwise Specified). Assessments were conducted at four time points, baseline (Time 1), 6 months (Time 2), 12 months (Time 3) and 18 months (Time 4). At Time 1 there were 115 participants in the BPSD group, 37 in the DSD + TMS group, and 13 in the DSD group. Due to sample attrition in the DSD + TMS and DSD groups, at Time 2 these two groups had 38 participants, at Time 3, 35 participants, and at Time 4, 33 participants. Measures that assessed socio-demographic variables, IQ (Kaufman Brief Intelligence Test), mood and co-morbid diagnoses (Children’s Interview for Psychiatric Syndromes – Child and Parent form [ChIPS/P-ChIPS]), clinical presentation (Mania Rating Scale, Children’s Depression Rating Scale – Revised, Children’s Global Assessment Scale, duration of prodromes), family environment (Coddington’s Life Events Scale, Expressed Emotion Adjective Checklist) and family history (Family History Research Diagnostic Criteria, Parental Mood Severity Index [calculated using Hamilton Rating Scale for Depression and Mania Rating Scale]) were collected at Time 1. I hypothesized that: 1) at Time 1, children with DSD + TMS will have lower C-GAS scores than children with DSD but higher scores than children with BPSD; 2) children with DSD + TMS at Time 1 will convert to BPSD at follow-up at a higher rate than children with DSD at Time 1; 3) conversion rates differed will not differ for DSD + TMS participants regardless of treatment status; 4) children with DSD + TMS at Time 1 who convert to BPSD at follow–up (converted group) will have greater impairment in clinical presentation, family environment and/or family history compared to children with DSD + TMS at Time 1 who do not convert (non-converted group). A secondary hypothesis was: the converted group will be more impaired on components of clinical presentation, family environment and/or family history than the non-converted group. Hypothesis 1, 3 and 4 were not supported. Hypothesis 2 was supported. The conversion rate from DSD + TMS to BPSD was 48% whereas the conversion rate from DSD to BPSD was 12.5% suggesting that TMS in a DSD population is a risk factor for conversion. This is particularly important, as pharmacologic treatments for children with depression and/or ADHD can destabilize children with bipolar disorder (Geller et al., 1992; Reichart & Nolen, 2004). Contrary to the hypothesis, for DSD + TMS participants, the one year wait-list control group (WLC) conversion rate was 60% whereas the immediate treatment group (IMM) conversion rate was 16% suggesting that psychosocial treatment may be beneficial. The secondary hypothesis was supported only for C-GAS scores. The converted group had lower C-GAS scores at Time 1 than the non-converted group. Clinical descriptions of converters and non-converters, limitations, clinical implication and future research ideas are discussed.
Mary Fristad, PhD (Advisor)
Steven Beck, PhD (Committee Member)
Julian Thayer, PhD (Committee Member)
James McAuley, PhD (Committee Member)
93 p.
Psychology
depression; mania; hypomania; irritability; children; conversion; bipolar disorder; depressive disorder; aggression; medication; dysthymia; major depressive disorder; risk factors; family history; family environment; clinical presentation; C-GAS; ADHD

Recommended Citations

Citations

  • Nadkarni-DeAngelis, R. B. (2009). Clinical Course of Children with a Depressive Spectrum Disorder and Transient Manic Symptoms [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1242225627

    APA Style (7th edition)

  • Nadkarni-DeAngelis, Radha. Clinical Course of Children with a Depressive Spectrum Disorder and Transient Manic Symptoms. 2009. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1242225627.

    MLA Style (8th edition)

  • Nadkarni-DeAngelis, Radha. "Clinical Course of Children with a Depressive Spectrum Disorder and Transient Manic Symptoms." Doctoral dissertation, Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1242225627

    Chicago Manual of Style (17th edition)

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© 2009, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.