Clinical correlates of socioeconomic status in adolescent bipolar disorder
Background: Lower socioeconomic status (SES) is associated with symptomatic severity, comorbidity, and functional impairment in adults with bipolar disorder (BD). Little is known about clinical correlates of SES in adolescents with BD. Methods: Participants included 195 adolescents, 13–20 years old,...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | Comprehensive Psychiatry |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0010440X20300286 |
| _version_ | 1818151389150314496 |
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| author | Weicong Lu Mikaela K. Dimick Lisa M. Fiksenbaum Vanessa Timmins Rachel H.B. Mitchell Yi Zou Benjamin I. Goldstein |
| author_facet | Weicong Lu Mikaela K. Dimick Lisa M. Fiksenbaum Vanessa Timmins Rachel H.B. Mitchell Yi Zou Benjamin I. Goldstein |
| author_sort | Weicong Lu |
| collection | DOAJ |
| description | Background: Lower socioeconomic status (SES) is associated with symptomatic severity, comorbidity, and functional impairment in adults with bipolar disorder (BD). Little is known about clinical correlates of SES in adolescents with BD. Methods: Participants included 195 adolescents, 13–20 years old, with BD type I, II or not otherwise specified (NOS). Diagnoses were determined by standardized semi-structured interviews. Based on the Hollingshead scale, participants were divided into “low” (SES 1–3) and the “high” (SES 4–5) SES groups. Demographic and clinical correlates of SES were evaluated in univariate analyses; significant variables were evaluated in a logistic regression model. Results: Compared to participants in the high SES group (n = 150), participants in the low SES group (n = 45) were significantly younger, less likely to be of Caucasian race and living with natural parents. In the logistic regression model, controlling for age and race, the low SES group had higher risk of police contact or arrest (OR = 2.41, 95% CI:1.14–5.11, p = 0.022), less treatment with stimulants(OR = 0.20 95% CI: 0.06–0.67, p = 0.009), and more post-traumatic stress disorder (PTSD) (OR = 4.08, 95% CI:1.33–12.46, p = 0.014) compared to the high SES group. In sensitivity analyses that further controlled for intact family, the finding of higher rates of police contact or arrest was no longer significant. Limitations: Cross-sectional design; higher-skewed SES sample. Conclusions: Lower SES in adolescent BD is associated with higher legal risk, increased PTSD, and under-treatment of attention-deficit/hyperactivity disorder (ADHD). Future studies are needed to evaluate the inter-relationships of these correlates, using prospective designs that can evaluate the direction of these associations. Further studies incorporating neurobiological markers are also needed to explore mechanisms underlying SES-related differences in BD. |
| first_indexed | 2024-12-11T13:38:03Z |
| format | Article |
| id | doaj.art-87da5f8a75b846f684321b8c19c0ef58 |
| institution | Directory Open Access Journal |
| issn | 0010-440X |
| language | English |
| last_indexed | 2024-12-11T13:38:03Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Comprehensive Psychiatry |
| spelling | doaj.art-87da5f8a75b846f684321b8c19c0ef582022-12-22T01:04:55ZengElsevierComprehensive Psychiatry0010-440X2020-08-01101152186Clinical correlates of socioeconomic status in adolescent bipolar disorderWeicong Lu0Mikaela K. Dimick1Lisa M. Fiksenbaum2Vanessa Timmins3Rachel H.B. Mitchell4Yi Zou5Benjamin I. Goldstein6Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou HuiAi Hospital), No.36 MingXin Road, LiWan District, Guangzhou, Guangdong 510370, China; Postgraduate Medical Education, University of Toronto, 602-500 University Avenue, Toronto, ON M5G 1V7, CanadaCentre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Science Building, Rm 4207 1 King's College Circle, Toronto, ON M5S 1A8, CanadaCentre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, CanadaCentre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, CanadaCentre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, CanadaCentre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Science Building, Rm 4207 1 King's College Circle, Toronto, ON M5S 1A8, CanadaCentre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Science Building, Rm 4207 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Corresponding author at: Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue EG48, Toronto, ON M4N 3M5, Canada.Background: Lower socioeconomic status (SES) is associated with symptomatic severity, comorbidity, and functional impairment in adults with bipolar disorder (BD). Little is known about clinical correlates of SES in adolescents with BD. Methods: Participants included 195 adolescents, 13–20 years old, with BD type I, II or not otherwise specified (NOS). Diagnoses were determined by standardized semi-structured interviews. Based on the Hollingshead scale, participants were divided into “low” (SES 1–3) and the “high” (SES 4–5) SES groups. Demographic and clinical correlates of SES were evaluated in univariate analyses; significant variables were evaluated in a logistic regression model. Results: Compared to participants in the high SES group (n = 150), participants in the low SES group (n = 45) were significantly younger, less likely to be of Caucasian race and living with natural parents. In the logistic regression model, controlling for age and race, the low SES group had higher risk of police contact or arrest (OR = 2.41, 95% CI:1.14–5.11, p = 0.022), less treatment with stimulants(OR = 0.20 95% CI: 0.06–0.67, p = 0.009), and more post-traumatic stress disorder (PTSD) (OR = 4.08, 95% CI:1.33–12.46, p = 0.014) compared to the high SES group. In sensitivity analyses that further controlled for intact family, the finding of higher rates of police contact or arrest was no longer significant. Limitations: Cross-sectional design; higher-skewed SES sample. Conclusions: Lower SES in adolescent BD is associated with higher legal risk, increased PTSD, and under-treatment of attention-deficit/hyperactivity disorder (ADHD). Future studies are needed to evaluate the inter-relationships of these correlates, using prospective designs that can evaluate the direction of these associations. Further studies incorporating neurobiological markers are also needed to explore mechanisms underlying SES-related differences in BD.http://www.sciencedirect.com/science/article/pii/S0010440X20300286Bipolar disorderSocioeconomic statusPoliceAdolescentAttention deficit hyperactivity disorderPost-traumatic stress disorder |
| spellingShingle | Weicong Lu Mikaela K. Dimick Lisa M. Fiksenbaum Vanessa Timmins Rachel H.B. Mitchell Yi Zou Benjamin I. Goldstein Clinical correlates of socioeconomic status in adolescent bipolar disorder Comprehensive Psychiatry Bipolar disorder Socioeconomic status Police Adolescent Attention deficit hyperactivity disorder Post-traumatic stress disorder |
| title | Clinical correlates of socioeconomic status in adolescent bipolar disorder |
| title_full | Clinical correlates of socioeconomic status in adolescent bipolar disorder |
| title_fullStr | Clinical correlates of socioeconomic status in adolescent bipolar disorder |
| title_full_unstemmed | Clinical correlates of socioeconomic status in adolescent bipolar disorder |
| title_short | Clinical correlates of socioeconomic status in adolescent bipolar disorder |
| title_sort | clinical correlates of socioeconomic status in adolescent bipolar disorder |
| topic | Bipolar disorder Socioeconomic status Police Adolescent Attention deficit hyperactivity disorder Post-traumatic stress disorder |
| url | http://www.sciencedirect.com/science/article/pii/S0010440X20300286 |
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