Characteristics of children with elevated symptoms of mania: The Longitudinal Assessment of Manic Symptoms (LAMS) study

Robert L Findling, Eric A. Youngstrom, Mary A. Fristad, Boris Birmaher, Robert A. Kowatch, L. Eugene Arnold, Thomas W. Frazier, David Axelson, Neal Ryan, Christine A. Demeter, Mary Kay Gill, Benjamin Fields, Judith Depew, Shawn M. Kennedy, Linda Marsh, Brieana M. Rowles, Sarah McCue Horwitz

Research output: Contribution to journalArticle

Abstract

Objective: The aim of the Longitudinal Assessment of Manic Symptoms (LAMS) study is to examine differences in psychiatric symptomatology, diagnoses, demographics, functioning, and psychotropic medication exposure in children with elevated symptoms of mania (ESM) compared to youth without ESM. This article describes the initial demographic information, diagnostic and symptom prevalence, and medication exposure for the LAMS cohort that will be followed longitudinally. Method: Guardians of consecutively ascertained new outpatients 6 to 12 years of age presenting for treatment at one of 10 university-affiliated mental health centers were asked to complete the Parent General Behavior Inventory-10-Item Mania Scale (PGBI-10M). Patients with scores ≥ 12 on the PGBI-10M (ESM+) and a matched sample of patients who screened negative (ESM-) were invited to participate. Patients were enrolled from December 13, 2005, to December 18, 2008. Results: 707 children (621 ESM+, 86 ESM-; mean [SD] age = 9.4 [2.0] years) were evaluated. The ESM+ group, compared to the ESM- group, more frequently met DSM-IV criteria for a mood disorder (P <.001), bipolar spectrum disorders (BPSD; P <.001), and disruptive behavior disorders (P <.01). Furthermore, they showed poorer overall functioning and more severe manic, depressive, attention-deficit/hyperactivity, disruptive behavioral, and anxiety symptoms. Nevertheless, rates of BPSD were relatively low in the ESM+ group (25%), with almost half of these BPSD patients (12.1% of ESM+ patients) meeting DSM-IV criteria for bipolar disorder not otherwise specified. ESM+ children with BPSD had significantly more of the following: current prescriptions for antipsychotics, mood stabilizers, and anticonvulsants (P <.001 for each); psychiatric hospitalizations (P <.001); and biological parents with elevated mood (P = .001 for mothers, P <.013 for fathers). ESM+ children with BPSD were also lower functioning compared to ESM+ children without BPSD. Conclusions: Although ESM+ was associated with higher rates of BPSD than ESM-, 75% of ESM+ children did not meet criteria for BPSD. Results suggest that longitudinal assessment is needed to examine which factors are associated with diagnostic evolution to BPSD in children with elevated symptoms of mania.

Original languageEnglish (US)
Pages (from-to)1664-1672
Number of pages9
JournalJournal of Clinical Psychiatry
Volume71
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

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Symptom Assessment
Bipolar Disorder
Diagnostic and Statistical Manual of Mental Disorders
Demography
Attention Deficit and Disruptive Behavior Disorders
Equipment and Supplies
Behavioral Symptoms

ASJC Scopus subject areas

  • Psychiatry and Mental health

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Characteristics of children with elevated symptoms of mania : The Longitudinal Assessment of Manic Symptoms (LAMS) study. / Findling, Robert L; Youngstrom, Eric A.; Fristad, Mary A.; Birmaher, Boris; Kowatch, Robert A.; Arnold, L. Eugene; Frazier, Thomas W.; Axelson, David; Ryan, Neal; Demeter, Christine A.; Gill, Mary Kay; Fields, Benjamin; Depew, Judith; Kennedy, Shawn M.; Marsh, Linda; Rowles, Brieana M.; Horwitz, Sarah McCue.

In: Journal of Clinical Psychiatry, Vol. 71, No. 12, 12.2010, p. 1664-1672.

Research output: Contribution to journalArticle

Findling, RL, Youngstrom, EA, Fristad, MA, Birmaher, B, Kowatch, RA, Arnold, LE, Frazier, TW, Axelson, D, Ryan, N, Demeter, CA, Gill, MK, Fields, B, Depew, J, Kennedy, SM, Marsh, L, Rowles, BM & Horwitz, SM 2010, 'Characteristics of children with elevated symptoms of mania: The Longitudinal Assessment of Manic Symptoms (LAMS) study', Journal of Clinical Psychiatry, vol. 71, no. 12, pp. 1664-1672. https://doi.org/10.4088/JCP.09m05859yel
Findling, Robert L ; Youngstrom, Eric A. ; Fristad, Mary A. ; Birmaher, Boris ; Kowatch, Robert A. ; Arnold, L. Eugene ; Frazier, Thomas W. ; Axelson, David ; Ryan, Neal ; Demeter, Christine A. ; Gill, Mary Kay ; Fields, Benjamin ; Depew, Judith ; Kennedy, Shawn M. ; Marsh, Linda ; Rowles, Brieana M. ; Horwitz, Sarah McCue. / Characteristics of children with elevated symptoms of mania : The Longitudinal Assessment of Manic Symptoms (LAMS) study. In: Journal of Clinical Psychiatry. 2010 ; Vol. 71, No. 12. pp. 1664-1672.
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abstract = "Objective: The aim of the Longitudinal Assessment of Manic Symptoms (LAMS) study is to examine differences in psychiatric symptomatology, diagnoses, demographics, functioning, and psychotropic medication exposure in children with elevated symptoms of mania (ESM) compared to youth without ESM. This article describes the initial demographic information, diagnostic and symptom prevalence, and medication exposure for the LAMS cohort that will be followed longitudinally. Method: Guardians of consecutively ascertained new outpatients 6 to 12 years of age presenting for treatment at one of 10 university-affiliated mental health centers were asked to complete the Parent General Behavior Inventory-10-Item Mania Scale (PGBI-10M). Patients with scores ≥ 12 on the PGBI-10M (ESM+) and a matched sample of patients who screened negative (ESM-) were invited to participate. Patients were enrolled from December 13, 2005, to December 18, 2008. Results: 707 children (621 ESM+, 86 ESM-; mean [SD] age = 9.4 [2.0] years) were evaluated. The ESM+ group, compared to the ESM- group, more frequently met DSM-IV criteria for a mood disorder (P <.001), bipolar spectrum disorders (BPSD; P <.001), and disruptive behavior disorders (P <.01). Furthermore, they showed poorer overall functioning and more severe manic, depressive, attention-deficit/hyperactivity, disruptive behavioral, and anxiety symptoms. Nevertheless, rates of BPSD were relatively low in the ESM+ group (25{\%}), with almost half of these BPSD patients (12.1{\%} of ESM+ patients) meeting DSM-IV criteria for bipolar disorder not otherwise specified. ESM+ children with BPSD had significantly more of the following: current prescriptions for antipsychotics, mood stabilizers, and anticonvulsants (P <.001 for each); psychiatric hospitalizations (P <.001); and biological parents with elevated mood (P = .001 for mothers, P <.013 for fathers). ESM+ children with BPSD were also lower functioning compared to ESM+ children without BPSD. Conclusions: Although ESM+ was associated with higher rates of BPSD than ESM-, 75{\%} of ESM+ children did not meet criteria for BPSD. Results suggest that longitudinal assessment is needed to examine which factors are associated with diagnostic evolution to BPSD in children with elevated symptoms of mania.",
author = "Findling, {Robert L} and Youngstrom, {Eric A.} and Fristad, {Mary A.} and Boris Birmaher and Kowatch, {Robert A.} and Arnold, {L. Eugene} and Frazier, {Thomas W.} and David Axelson and Neal Ryan and Demeter, {Christine A.} and Gill, {Mary Kay} and Benjamin Fields and Judith Depew and Kennedy, {Shawn M.} and Linda Marsh and Rowles, {Brieana M.} and Horwitz, {Sarah McCue}",
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TY - JOUR

T1 - Characteristics of children with elevated symptoms of mania

T2 - The Longitudinal Assessment of Manic Symptoms (LAMS) study

AU - Findling, Robert L

AU - Youngstrom, Eric A.

AU - Fristad, Mary A.

AU - Birmaher, Boris

AU - Kowatch, Robert A.

AU - Arnold, L. Eugene

AU - Frazier, Thomas W.

AU - Axelson, David

AU - Ryan, Neal

AU - Demeter, Christine A.

AU - Gill, Mary Kay

AU - Fields, Benjamin

AU - Depew, Judith

AU - Kennedy, Shawn M.

AU - Marsh, Linda

AU - Rowles, Brieana M.

AU - Horwitz, Sarah McCue

PY - 2010/12

Y1 - 2010/12

N2 - Objective: The aim of the Longitudinal Assessment of Manic Symptoms (LAMS) study is to examine differences in psychiatric symptomatology, diagnoses, demographics, functioning, and psychotropic medication exposure in children with elevated symptoms of mania (ESM) compared to youth without ESM. This article describes the initial demographic information, diagnostic and symptom prevalence, and medication exposure for the LAMS cohort that will be followed longitudinally. Method: Guardians of consecutively ascertained new outpatients 6 to 12 years of age presenting for treatment at one of 10 university-affiliated mental health centers were asked to complete the Parent General Behavior Inventory-10-Item Mania Scale (PGBI-10M). Patients with scores ≥ 12 on the PGBI-10M (ESM+) and a matched sample of patients who screened negative (ESM-) were invited to participate. Patients were enrolled from December 13, 2005, to December 18, 2008. Results: 707 children (621 ESM+, 86 ESM-; mean [SD] age = 9.4 [2.0] years) were evaluated. The ESM+ group, compared to the ESM- group, more frequently met DSM-IV criteria for a mood disorder (P <.001), bipolar spectrum disorders (BPSD; P <.001), and disruptive behavior disorders (P <.01). Furthermore, they showed poorer overall functioning and more severe manic, depressive, attention-deficit/hyperactivity, disruptive behavioral, and anxiety symptoms. Nevertheless, rates of BPSD were relatively low in the ESM+ group (25%), with almost half of these BPSD patients (12.1% of ESM+ patients) meeting DSM-IV criteria for bipolar disorder not otherwise specified. ESM+ children with BPSD had significantly more of the following: current prescriptions for antipsychotics, mood stabilizers, and anticonvulsants (P <.001 for each); psychiatric hospitalizations (P <.001); and biological parents with elevated mood (P = .001 for mothers, P <.013 for fathers). ESM+ children with BPSD were also lower functioning compared to ESM+ children without BPSD. Conclusions: Although ESM+ was associated with higher rates of BPSD than ESM-, 75% of ESM+ children did not meet criteria for BPSD. Results suggest that longitudinal assessment is needed to examine which factors are associated with diagnostic evolution to BPSD in children with elevated symptoms of mania.

AB - Objective: The aim of the Longitudinal Assessment of Manic Symptoms (LAMS) study is to examine differences in psychiatric symptomatology, diagnoses, demographics, functioning, and psychotropic medication exposure in children with elevated symptoms of mania (ESM) compared to youth without ESM. This article describes the initial demographic information, diagnostic and symptom prevalence, and medication exposure for the LAMS cohort that will be followed longitudinally. Method: Guardians of consecutively ascertained new outpatients 6 to 12 years of age presenting for treatment at one of 10 university-affiliated mental health centers were asked to complete the Parent General Behavior Inventory-10-Item Mania Scale (PGBI-10M). Patients with scores ≥ 12 on the PGBI-10M (ESM+) and a matched sample of patients who screened negative (ESM-) were invited to participate. Patients were enrolled from December 13, 2005, to December 18, 2008. Results: 707 children (621 ESM+, 86 ESM-; mean [SD] age = 9.4 [2.0] years) were evaluated. The ESM+ group, compared to the ESM- group, more frequently met DSM-IV criteria for a mood disorder (P <.001), bipolar spectrum disorders (BPSD; P <.001), and disruptive behavior disorders (P <.01). Furthermore, they showed poorer overall functioning and more severe manic, depressive, attention-deficit/hyperactivity, disruptive behavioral, and anxiety symptoms. Nevertheless, rates of BPSD were relatively low in the ESM+ group (25%), with almost half of these BPSD patients (12.1% of ESM+ patients) meeting DSM-IV criteria for bipolar disorder not otherwise specified. ESM+ children with BPSD had significantly more of the following: current prescriptions for antipsychotics, mood stabilizers, and anticonvulsants (P <.001 for each); psychiatric hospitalizations (P <.001); and biological parents with elevated mood (P = .001 for mothers, P <.013 for fathers). ESM+ children with BPSD were also lower functioning compared to ESM+ children without BPSD. Conclusions: Although ESM+ was associated with higher rates of BPSD than ESM-, 75% of ESM+ children did not meet criteria for BPSD. Results suggest that longitudinal assessment is needed to examine which factors are associated with diagnostic evolution to BPSD in children with elevated symptoms of mania.

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