Discrimination and manic symptoms in early adolescence: A prospective cohort study

Purpose: This study aims to investigate the prospective associations between four types of perceived discrimination (country of origin, race and ethnicity, sexual orientation, and weight) and the development of manic symptoms in a diverse, nationwide sample of adolescents aged 9–14 years in the U.S. Methods: We analyzed prospective cohort data from the Adolescent Brain Cognitive Development Study (N = 7466; ages 9–14 years at Year 1 or 2 in 2017–2020; 48.5 % female; 39.4 % racial/ethnic minority). Multiple zero-inflated negative binomial analyses were conducted to examine the associations between Year 1 or 2 discrimination (by country of origin, race and ethnicity, sexual orientation, weight, sum score), and Year 3 manic symptoms (7 Up Mania scale), adjusting for covariates (age, sex, race and ethnicity, household income, parental education, sipping alcohol, puffing tobacco, anxiety symptoms, depressive symptoms, Year 1 manic symptoms, and study site). Results: After adjusting for covariates, perceived discrimination based on country of origin (incidence rate ratio [IRR] = 1.46; 95 % confidence interval [CI] 1.15–1.86), sexual orientation (IRR = 1.36; 95 % CI 1.21–1.53), race and ethnicity (IRR = 1.28; 95 % CI 1.13–1.46), weight (IRR = 1.21 95 % CI 1.09–1.34), and sum scores (IRR = 1.18 5 % CI 1.12–1.24), were significantly associated with higher manic symptoms. Conclusion: Perceived discrimination based on country of origin, race and ethnicity, sexual orientation, weight, and sum scores, are prospectively associated with greater manic symptoms in adolescents. These findings underscore the need for targeted interventions to address discrimination and associated psychological impacts. Efforts to reduce discrimination and to support affected adolescents are important components of comprehensive mental health care and public health strategies.