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Development and Predictors of Bipolar Disorder in Children and Adolescents with Depressive Disorders A Systematic Review, Meta-analysis and Meta-regression

Lookup NU author(s): Dr Aastha Sharma

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© The Author(s), 2025.Background: Estimating the risk of developing bipolar disorder (BD) in children and adolescents (C&A) with depressive disorders and identifying predictors for developing BD is important to optimize prevention and early intervention efforts. This systematic review and meta-analysis aimed to quantitatively examine this risk of developing BD from depressive disorders and identify factors which moderate this development. Methods: In this systematic review and meta-analysis (PROSPERO:CRD42023431301), PubMed and Web-of-Science databases were searched for longitudinal studies reporting the percentage of C&A with ICD/DSM-defined depressive disorders who developed BD during follow-up. Data extraction, random-effects meta-analysis, between-study heterogeneity analysis, quality assessment, sub-group analyses and meta-regressions were conducted. Results: 39 studies were included, including 72,371 individuals (mean age=13.9 years, 57.1% females). 14.7% of C&A with a depressive disorder developed BD after 20.4–288 months: 9.5% developed BD-I (95%CI=4.7–18.1); 7.7% developed BD-II (95%CI=3.2–17.3%). 19.8% (95%CI=9.9–35.6%) of C&A admitted into the hospital with a depressive disorder developed BD. Studies using the DSM (21.6%, 95%CI=20.2-23.1%) and studies evaluating C&A with a major depressive disorder only (19.8%, 95%CI=16.8-23.1%) found higher rates of development of BD. Younger age at baseline, a history of hospitalization and recruitment from specialized clinics were associated with an increased risk of developing BD at follow-up. Quality of included studies was good in 76.9% studies. Conclusions: There is a substantial risk of developing BD in C&A with depressive disorders. This is particularly the case for C&A with MDD, DSM-diagnosed depressive disorders, and C&A admitted into hospital. Research exploring additional predictors and preventive interventions is crucial.

Publication metadata

Author(s): de Pablo GS, Perez-Rodriguez V, de Otazu Olivares J, Camacho-Rubio J, Sharma A, Catalan A, Breedvelt J, Aymerich C, Pop M, Moreno C, Kelleher I, Anderson J, Fusar-Poli P, Correll CU, Young AH

Publication type: Review

Publication status: Published

Journal: European Psychiatry

Year: 2025

Volume: 68

Issue: 1

Pages: 1-9

Online publication date: 08/01/2025

Acceptance date: 14/12/2024

ISSN (print): 0924-9338

ISSN (electronic): 1778-3585

Publisher: Cambridge University Press

URL: https://doi.org/10.1192/j.eurpsy.2024.1814

DOI: 10.1192/j.eurpsy.2024.1814

Data Access Statement: Data were obtained from the cited articles.

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