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A new finding hints at a better prognosis for bipolar youth.

Nearly half of those suffering from bipolar disorder, a psychiatric condition also known as manic-depressive illness, are diagnosed in their early 20s. For those with a severe form of the condition, the effects—both for patients and their loved ones—can be devastating.

Manic episodes leave patients oddly euphoric, restless and giddy; their minds race with ideas and agendas that may be unrealistic. Impulse control becomes a problem. Patients often set aside their typical discretion in favor of high-risk behaviors involving spending and sex.

Depressive periods push patients to the opposite extreme. They report feeling “slowed down,” unnaturally listless and disengaged. They have trouble concentrating and making decisions. Some sleep too much, others too little. Thoughts of death and suicide are not uncommon.

While there are treatments affording patients some degree of control over their mood swings, there is no cure. Individuals with bipolar disorder are typically told they will need life-long care to control the illness.

Recent evidence suggests this gloomy prognosis may be overstated. A new epidemiological analysis of two “large, nationally representative studies,” led by MU psychology doctoral student David Cicero, indicates the symptoms of bipolar disorder in young people may fade as they age. “During the third decade of life, the prevalence of the disorder appears to resolve substantially, suggesting patients become less symptomatic and may have a greater chance of recovery,” Cicero says, although he cautions that some, but not all, of the offset in diagnoses could be due to methodological limitations or the early mortality of bipolar patients.

Along with his MU colleagues Kenneth Sher, Curators’ Professor in psychological sciences, and doctoral student Amee Epler, Cicero found that 5.5 percent to 6.2 percent of people between the ages of 18 and 24 live with bipolar disorder, but only about 3 percent of people older than 29 have the disorder.

The reason why is unclear, but the researchers say both environmental and physiological causes could be responsible.

“Young adults between the ages of 18 and 24 are going through significant life changes and social strain, which could influence both the onset and course of the disorder,” says Sher. “During this period of life, young adults are exploring new roles and relationships and begin to leave their parents’ homes for school or work. By the mid-20s, adults have begun to adjust to these changes and begin to settle down and form committed relationships.”

Brain development, particularly that of the prefrontal cortex, may also be a factor, says Cicero. The prefrontal cortex is the area of the brain thought to influence personality, decision making and day-to-day problem solving. “The maturing of the prefrontal cortex of the brain around 25 years of age could biologically explain the developmentally limited aspect of bipolar disorder,” Cicero says. “Other researchers have found a similar pattern in young adults with alcohol or substance abuse disorders.”

The study, Are There Developmentally Limited Forms of Bipolar Disorder? was published in the August 2009 edition of the Journal of Abnormal Psychology.

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University of Missouri

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