Bipolar Disorder in Young Adults Posted on December 3, 2007 Terence A. Ketter (bio) discusses the research opportunities afforded by the longitudinal design of STEP-BD.

One of the benefits of being in the same place for a sustained period of time, is that you can do longitudinal studies. And we’ve been one of the sites in the Systematic Treatment Enhancement Program [STEP-BD] and have over seven years of longitudinal data on all our patients. So every patient we see, every visit, we’re collecting eighty data fields.

And so that pretty well everything we do, be it clinical treatment, be it evaluations, it’s all researchable. And so the participants in our program, when they come in, they sign a consent form that their clinical information is going to be deidentified and archived and accumulated with other individuals to do statistical analyses. And so that we have more data than we can possibly analyze.

And so part of the challenge there is figuring out what topics to go after.
Thinking in terms of our collaboration with Kiki Chang and his pediatric group, we’ve had patients who have been treated in Kiki’s clinic up to the age of eighteen and then we take over treatment when they’re eighteen years of age and have had opportunity to watch individuals as they progress from adolescence into young adulthood. And one of the things our group has been particularly interested in is bipolar disorder in young adulthood. It seems to be an overlooked kind of phase of the illness.

About fifteen percent of our patients are Stanford students, and we get graduates from Kiki’s program. So we see two different types of eighteen year olds. Some individuals who have had the illness since their preteen years and have a bipolar parent, and actually they’re having a pretty tough time.

And then other individuals who have a relatively recent onset of the illness, don’t have a bipolar parent, and in fact are doing quite well and they’re quite easy to treat. And we’re having an opportunity to watch both of these populations over time and see how the developmental process, which in a lot of people’s thinking, gets arrested when people are eighteen years of age, but how that process in fact continues on into young adulthood.

And there certainly are differences in the college years in maturity and in the clinical presentations we see enormous amount of risk of substance abuse in college populations, a lot of peer pressure, a lot of performance anxiety, particularly at a school like Stanford which has high demands on the students. And so it has been one of our particular interests to look at people as they go through their college years and we have the opportunity to do that with the research infrastructure we have.

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