{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:16:04Z","timestamp":1780632964273,"version":"3.54.1"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291717003233_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Identifying clinical features that predict conversion to bipolar disorder (BD) in those at high familial risk (HR) would assist in identifying a more focused population for early intervention.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291717003233_sec_a2\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>In total 287 participants aged 12\u201330 (163 HR with a first-degree relative with BD and 124 controls (CONs)) were followed annually for a median of 5 years. We used the baseline presence of DSM-IV depressive, anxiety, behavioural and substance use disorders, as well as a constellation of specific depressive symptoms (as identified by the Probabilistic Approach to Bipolar Depression) to predict the subsequent development of hypo\/manic episodes.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291717003233_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>At baseline, HR participants were significantly more likely to report \u2a7e4 Probabilistic features (40.4%) when depressed than CONs (6.7%; <jats:italic>p<\/jats:italic> &lt; .05). Nineteen HR subjects later developed either threshold (<jats:italic>n<\/jats:italic> = 8; 4.9%) or subthreshold (<jats:italic>n<\/jats:italic> = 11; 6.7%) hypo\/mania. The presence of \u2a7e4 Probabilistic features was associated with a seven-fold increase in the risk of \u2018conversion\u2019 to threshold BD (hazard ratio = 6.9, p &lt; .05) above and beyond the fourteen-fold increase in risk related to major depressive episodes (MDEs) <jats:italic>per se<\/jats:italic> (hazard ratio = 13.9, p &lt; .05). Individual depressive features predicting conversion were psychomotor retardation and \u2a7e5 MDEs. Behavioural disorders only predicted conversion to subthreshold BD (hazard ratio = 5.23, p &lt; .01), while anxiety and substance disorders did not predict either threshold or subthreshold hypo\/mania.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291717003233_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>This study suggests that specific depressive characteristics substantially increase the risk of young people at familial risk of BD going on to develop future hypo\/manic episodes and may identify a more targeted HR population for the development of early intervention programs.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291717003233","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T08:40:12Z","timestamp":1510044012000},"page":"1713-1721","source":"Crossref","is-referenced-by-count":19,"title":["Clinical predictors of conversion to bipolar disorder in a prospective longitudinal familial high-risk sample: focus on 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