Diagnosing BD does invoke mood-stabilizing medications as the foundation of treatment, which underscores the importance of differentiating BD from ADHD, major depressive disorder, and cases in which chronic irritability in the absence of hypomanic or manic episodes is salient. Adjunctive psychosocial interventions are also important and are increasingly supported by empirical data.
Biomarker validation is urgently needed. At present, differential diagnosis is challenging and requires rigorous and often time-consuming interviews that remain at least to some degree constrained by the subjective nature of current assessment strategies. Prevention, of BD or of accumulation of psychiatric and medical comorbidities, is a lofty but worthwhile challenge.
Given the deleterious effect of BD on psychological and emotional development, even delaying onset or progression of BD and its comorbidities would be a great success.
Controversies concerning the diagnosis and treatment of bipolar disorder in children
Correspondence: Benjamin I. Published Online: January 2, Financial Disclosure: Dr Goldstein reports that he has received investigator-initiated research support from Pfizer and speakers' honoraria from Purdue Pharma. All Rights Reserved. Download PDF Comment. View Large Download. Table 1. Table 2. Differential Diagnosis of Manic Symptoms.
The concept of bipolar disorder in children: a history of the bipolar controversy. Manic-Depressive Insanity and Paranoia. Barclay RM, trans. Edinburgh, Scotland: Livingstone; Further evidence for a developmental subtype of bipolar disorder defined by age at onset: results from the national epidemiologic survey on alcohol and related conditions.
Am J Psychiatry. The poor prognosis of childhood-onset bipolar disorder. J Pediatr. Long-term implications of early onset in bipolar disorder: data from the first participants in the systematic treatment enhancement program for bipolar disorder STEP-BD. Biol Psychiatry. Bipolar Disord. Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children.
Psychotropic practice patterns for youth: a year perspective. Service utilization for lifetime mental disorders in U. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry.
Lifetime prevalence of mental disorders in U. History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk. Quality of life in pediatric bipolar disorder. Risk of substance use disorders in adolescents with bipolar disorder. Rates, types, and psychosocial correlates of legal charges in adolescents with newly diagnosed bipolar disorder. Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: a systematic review and pooled analysis of short-term trials.
Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol.
- Bipolar Disorder In Children And Teens.
- Bipolar disorder: Causes, symptoms, and treatment?
- Bipolar Disorder (for Teens) - KidsHealth.
Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. How cardinal are cardinal symptoms in pediatric bipolar disorder? Irritability without elation in a large bipolar youth sample: frequency and clinical description. Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. Phenomenology of children and adolescents with bipolar spectrum disorders. The assessment of children and adolescents with bipolar disorder.
Pediatric bipolar disorder: validity, phenomenology, and recommendations for diagnosis. Comorbid substance use disorders among youth with bipolar disorder: opportunities for early identification and prevention. J Clin Psychiatry. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation. Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Different psychophysiological and behavioral responses elicited by frustration in pediatric bipolar disorder and severe mood dysregulation.
Current research in child and adolescent bipolar disorder.
Face emotion labeling deficits in children with bipolar disorder and severe mood dysregulation. Dev Psychopathol. Concerns regarding the inclusion of temper dysregulation disorder with dysphoria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. Child bipolar I disorder: prospective continuity with adult bipolar I disorder; characteristics of second and third episodes; predictors of 8-year outcome.
Twelve-month outcome of adolescents with bipolar disorder following first hospitalization for a manic or mixed episode.
A New Understanding of Risk for Bipolar Disorder
Clinical course of children and adolescents with bipolar spectrum disorders. Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients.
Psychiatric risk factors for adolescent suicide: a case-control study. Psychiatric adolescent inpatients: eight- to ten-year follow-up. Suicidality in pediatric bipolar disorder. Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up.
Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents. Comparison of manic and depressive symptoms between children and adolescents with bipolar spectrum disorders. Comorbidity with ADHD decreases response to pharmacotherapy in children and adolescents with acute mania: evidence from a metaanalysis. J Can Psychiatry. Comorbid anxiety in children and adolescents with bipolar spectrum disorders: prevalence and clinical correlates. Impact of obsessive-compulsive disorder on the antimanic response to olanzapine therapy in youth with bipolar disorder.
Bipolar: What to Look For
Substance use disorders among adolescents with bipolar spectrum disorders. Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States. Obesity as a correlate of outcome in patients with bipolar I disorder. A cohort study of the prevalence and impact of comorbid medical conditions in pediatric bipolar disorder. Medical comorbidity among youth diagnosed with bipolar disorder in the United States.
Preliminary findings regarding overweight and obesity in pediatric bipolar disorder. Bipolar offspring: a window into bipolar disorder evolution. Psychiatric symptoms and syndromes among adolescent children of parents with lithium-responsive or lithium-nonresponsive bipolar disorder. Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study.
1. Bipolar Disorder in Children
Clinical, demographic, and familial correlates of bipolar spectrum disorders among offspring of parents with bipolar disorder. Biological risk factors in pediatric bipolar disorder. Risk factors in relation to an emergence of bipolar disorder: a systematic review. Bipolar illness in adolescents with major depression: clinical, genetic, and psychopharmacologic predictors in a three- to four-year prospective follow-up investigation. Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort.
A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Fronto-limbic brain abnormalities in juvenile onset bipolar disorder.