The common bipolar phenotype in young people

Background: Mood elevation is common in adolescents and young adults. The aim of this study was to investigate the prevalence of a bipolar diagnosis and co-morbidity in individuals identified by online screening for experience of (hypo)manic symptoms in order to better define the common bipolar phenotype in young people. Methods: Survey data regarding experience of (hypo)manic symptoms and occurrence of co-morbidities were analysed for 106 students satisfying criteria for probable bipolar syndrome (≥7 mood elevation symptoms plus problems on the Mood Disorder Questionnaire (MDQ)), 459 threshold bipolar students (≥7 symptoms only) and 637 controls (zero symptoms). Co-morbidities investigated included neuroticism, depression, substance misuse, gambling, health problems and medication use. Twenty-one students satisfying criteria for probable bipolar syndrome, 71 threshold bipolar students and 43 controls were interviewed with the Mini International Neuropsychiatric Interview-Plus for diagnoses of DSM-IV-TR bipolar disorder I, II or not otherwise specified (NOS). Results and discussion: There was a higher incidence of bipolar diagnosis in probable bipolar (62%) compared to threshold bipolar (34%) individuals. The probable bipolar group had increased risk of co-morbidity for neuroticism, depression, substance misuse, gambling, health problems and medication use, shared to a lesser extent by the threshold bipolar group. Self-report screening for mood elevation detects a bipolar phenotype common in young people. It provides a bridge to bipolar disorder of potential interest in understanding psychopathology, treatment and prevention.