Risk factors associated with longitudinal trajectories of mania symptoms in youth

Objective: Mania symptoms in youth predict poor long-term mental health outcomes, yet their developmental trajectories and associated risk factors remain unclear. Methods: Leveraging data from the Adolescent Brain Cognitive Development Study (N=10,474; 9-10 years at baseline; 48% female, 65% white), we used latent growth mixture models to identify trajectories of mania symptoms across two years in early adolescence. We used multinomial logistic regressions to examine associations between trajectories and risk factors across mental and physical health, cognition, and family/environmental domains. Results: We identified three trajectories: Low (58%), Moderate (32%), and High/Variable Mania Symptoms (10%). All mental health symptoms (depression, attention deficit hyperactivity disorder, conduct and oppositional defiant disorders and anxiety), two physical health factors (sleep disturbances, irritable bowel syndrome symptoms), one cognitive factor (verbal learning impairment), and three family/environmental factors (trauma, parent- and youth-reported family conflict) significantly differentiated between all three trajectories, reflecting incremental increases in risk factor severity with increasing mania symptoms. Other physical, cognitive, family and environmental factors were also associated with more severe mania symptom trajectories. Conclusions: More severe mania symptom trajectories in early adolescence are associated with multiple mental, physical, cognitive, family and environmental risk factors, underscoring the need for comprehensive risk prediction approaches in youth.