{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T09:05:54Z","timestamp":1778317554859,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,12,5]],"date-time":"2013-12-05T00:00:00Z","timestamp":1386201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Gender\u2010specific rates of unipolar and bipolar disorders are well established for cases with post\u2010pubertal onset. However, there is less certainty about these rates in pre\u2010pubertal children. We undertook a systematic review of community studies that report gender\u2010specific rates for unipolar and bipolar disorders in young children, particularly cases of major depression and mania.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Computer databases (Medline,<jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>, Index to Theses, and PsychInfo) were searched for non\u2010clinical observational studies using recognized diagnostic criteria to identify unipolar and bipolar disorders in children aged \u226412\u00a0years. A meta\u2010analysis was undertaken to calculate pooled odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) for caseness for major depression by gender. The limited data on bipolar disorder were summarized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis of 12 studies (&gt;15,000 children), indicated that the community prevalence of unipolar disorders was higher in boys (1.3%) than in girls (0.8%). Rates of major depression were low (0.61%), but boys were significantly more likely to meet diagnostic criteria than girls (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.61; 95% confidence interval: 1.11\u20132.35). Five studies, assessing &gt;5,000 children, identified only one case with a probable diagnosis of mania.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This systematic review suggests that boys aged \u226412\u00a0years are significantly more likely to experience major depression than girls. However, in younger children, community rates of major depression are low, and it is frequently suggested (but not proven) that most cases are comorbid. The absence of mania suggests either that childhood bipolar phenotypes do not resemble post\u2010pubertal onset cases or that there are problems of case ascertainment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12155","type":"journal-article","created":{"date-parts":[[2013,12,5]],"date-time":"2013-12-05T09:36:40Z","timestamp":1386236200000},"page":"5-15","source":"Crossref","is-referenced-by-count":35,"title":["A systematic review of gender\u2010specific rates of unipolar and bipolar disorders in community studies of pre\u2010pubertal children"],"prefix":"10.1111","volume":"16","author":[{"given":"Jessica","family":"Douglas","sequence":"first","affiliation":[{"name":"Department of Paediatric Clinical Psychology Children's Services Addenbrooke's Hospital Cambridge UK"},{"name":"Institute of Neuroscience University of Newcastle Newcastle UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Scott","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience University of Newcastle Newcastle UK"},{"name":"Centre for Affective Disorders Institute of Psychiatry Kings College London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,12,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2011.00274.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10m06290"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.110.084517"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2011.00276.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2011.639801"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmh.11.2.60"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1111\/j.1469-7610.2006.01682.x","article-title":"Is there an epidemic of child or adolescent depression?","volume":"47","author":"Costello EJ","year":"2006","journal-title":"J Child Psychol Psychiaty"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(02)01372-0"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511543821"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2008.00580.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2002-0019"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_6_14_1","volume-title":"Comprehensive Meta\u2010Analysis","author":"Biostat","year":"2000"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00010699"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1987.01800130081010"},{"key":"e_1_2_6_17_1","first-page":"647","article-title":"Prevalence of childhood and adolescent depression in the community. 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