Cyclic GMP-AMP synthase (EC 2.7.7.86) (cGAMP synthase) (cGAS) (h-cGAS) (2'3'-cGAMP synthase) (Mab-21 domain-containing protein 1) [C6orf150] [MB21D1]
Rate, risk, and predictors of switching from attention-deficit/hyperactivity disorder (ADHD) to a prepubertal and early adolescent bipolar I disorder phenotype (PEA-BP-I) were examined in a blindly rated, controlled, prospective 6-year follow-up that included assessments at 2-year intervals. Subjects were outpatients obtained by consecutive new case ascertainment. There were 81 subjects who were 9.7 /- 2.0 years. Subjects had DSM-IV ADHD (hyperactive or combined subtypes); a Children's Global Assessment Scale (CGAS) score of < or =60, consistent with moderate-severe impairment; and no BP or major depressive disorder (MDD) diagnoses. PEA-BP-I was defined as DSM-IV BP I (manic or mixed phase), with cardinal symptoms (elation and/or grandiosity), to avoid diagnosing mania by symptoms that overlapped with those of ADHD, and by a CGAS score of < or =60. Morbid risk of switching to PEA-BP-I was 28.5%. Significant predictors of switching in a multivariate Cox model were more severe baseline CGAS, paternal recurrent MDD, and less stimulant use. BP I in first-degree relatives, antidepressants, psychosocial measures, and life events were not predictive.
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