Korean J Schizophr Res.  2022 Oct;25(2):62-68. 10.16946/kjsr.2022.25.2.62.

Probability of Transition to Psychosis and Bipolar Disorder in Individuals With Neurodevelopmental Disorders

• An S
• Choi BS
• Yu ER
• Jeong JW
• Huh SY

• KMID: 2535946
• DOI: http://doi.org/10.16946/kjsr.2022.25.2.62

Abstract

Objectives
The clinical trajectories of adolescent-onset psychosis and bipolar disorder are worse than that of adult-onset cases. Although psychosis and bipolar disorder are more prevalent among those with neurodevelopmental disorders such as ADHD and autism spectrum disorder compared with the general population, the incidence during adolescence has not yet been explored.
Methods
Out of 3,730 patients who visited the Department of Pediatric Psychiatry at Pusan National University Yangsan Hospital between November 2008 and May 2021, patients with neurodevelopmental disorders who did not meet the criteria for psychosis or bipolar disorder and had at least one year of the follow-up period were selected. A Kaplan-Meier analysis was performed to examine the cumulative incidence of psychosis and bipolar disorder in patients with neurodevelopmental disorders.
Results
The sample included 591 patients with neurodevelopmental disorders (mean age 12.6 years, range 10-18 years). The 9-years cumulative incidences of psychosis and bipolar disorder are 1.3% (95% CI=0.2%-2.4%), 11.6% (95% CI=7.4%-15.6%), respectively.
Conclusion
Patients with neurodevelopmental disorders showed a high incidence of psychosis and bipolar disorder during adolescence. This suggests that patients diagnosed with neurodevelopmental disorders should be continuously evaluated and monitored of the occurrence of comorbidities during adolescence.

Keyword

Bipolar disorder; Incidence; Neurodevelopmental disorder; Probability; Psychotic disorder; Schizophrenia; 발생률; 신경발달장애; 양극성 장애; 정신병적 장애; 조현병; 확률

Figure

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  Fig. 1. Flow chart of study population selection.

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  Fig. 2. Kaplan–Meier curve of Psychosis group incidence. The Kaplan– Meier survival estimates per analysis showing the estimated cumulative incidences of individuals with neurodevelopmental disorders registered in Department of Pediatric Psychiatry at Pusan National University Hospital with a Psychosis group by months. The 1, 3, 9-years cumulative incidences of psychosis group are 0.3% (95% CI=0.0%-0.8%), 1% (95% CI=0.1%-1.9%), 1.3% (95% CI= 0.2%-2.4%), respectively.

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  Fig. 3. Kaplan–Meier curve of Bipolar disorders group incidence. The Kaplan–Meier survival estimates per analysis showing the estimated cumulative incidences of individuals with neurodevelopmental disorders registered in Department of Pediatric Psychiatry at Pusan National University Hospital with a Bipolar disorder group by months. The 1, 3, 9-years cumulative incidences of bipolar disorder group are 2.7% (95% CI=1.4%-4.0%), 4.8% (95% CI= 3.0%-6.4%), 11.6% (95% CI=7.4%-15.6%), respectively.

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  Fig. 4. Kaplan–Meier curve of Psychosis-bipolar disorders group incidence. The Kaplan–Meier survival estimates per analysis showing the estimated cumulative incidences of individuals with neurodevelopmental disorders registered in Department of Pediatric Psychiatry at Pusan National University Hospital with a Psychosis- Bipolar disorder group by months. The 1, 3, 9-years cumulative incidences of psychosis-bipolar disorder group are 3.0% (95% CI= 1.6%-4.4%), 5.8% (95% CI=3.7%-7.7%), 12.8% (95% CI=8.5%-16.9%), respectively.

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