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Abstract
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Aims: The prevalence of paediatric bipolar disorder (BD) is < 1% in the United States and 0-0.1% in the United Kingdom (UK). The characteristics and clinical outcomes of children and young people (CYP) at risk of BD who are referred to Child and Adolescent Mental Health Services (CAMHS) in the UK have not been widely studied. Methods: Participants were 305 CYP aged 11-17 years (routine non-urgent referrals). CYP and/or parent/carer completed the mania section of the Development and Wellbeing Assessment (DAWBA). CYP were categorised as ‘very unlikely’ (75%), ‘unlikely’ (22%), and ‘possible’ (3%) for BD using a validated computerised diagnostic algorithm, and followed up for 12 months. Results and Conclusions: CYP at ‘possible’ risk of BD were young (mean age=13) and of higher socioeconomic status. These CYP were likely to have their CAMHS referral accepted (89%), and treatment/ intervention offered (67%) and started (56%) within 12 months of the referral. The diagnostic algorithm also indicated that these CYP had social phobia, generalised anxiety disorder, and depression at baseline. A third of them were clinically diagnosed with these disorders and obsessive-compulsive disorder within 12 months. There was an increasing gradient pattern between the risk of BD and self-harm thoughts and behaviour. In conclusion, CYP at ‘possible’ risk of BD were more likely to have their referrals to CAMHS accepted and receive CAMHS input. However, they have high self-harm risk and poor outcomes. Comorbid emotional disorders among these CYP should also be considered.
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