Mania profile in a community sample of prepubertal children in Turkey

Background: Mania in youth is increasingly recognized and accompanied by substantial psychiatric and psychosocial morbidity. There are no data on prepubertals in the general population and we aimed to search for mania symptoms and its clinical correlations in a community sample of prepubertal Turkish children. Methods: Among all children (n = 56,335) aged 7-11 in Adana, Turkey, 2,468 children (48% girls) were randomly included. Parents completed Child Behavior Checklist (CBCL) 4-18 and Parent-Young Mania Rating Scale (P-YMRS). Cut-off scores of 17 and 27 on total P-YMRS were defined as efficient (probable-mania group) and specific (mania group), respectively, for bipolar profile. We searched for clinical correlations and used logistic regression to show how well each CBCL subscale predicted the presence of mania and probable-mania, after adjusting for any demographic differences. Results: Parent-Young Mania Rating Scale scores were >= 17 but < 27 (probable-mania) in 155 (6.3%) children and >= 27 (mania) in 32 (1.3%) children. Elevated mood, increased activity levels, and poor insight were the most frequent manic symptoms in our sample. Children with probable-mania and mania had higher scores on all CBCL subscales and the CBCL-Pediatric Bipolar Disorder (CBCL-PBD) profile (sum of attention, aggression, and anxiety/depression subscales). Logistic regression analysis revealed only thought problems on CBCL that predicted probable-mania and mania. Conclusion: Our study shows that mania profile is common in the community sample of Turkish prepubertal children and does not support the thought that mania is rare outside the US. We need further population-based studies that will use diagnostic interviews and multiple informants.