GLF is a consultant for Abbott, Shire, Solvay. RJB has received grant/research support from Eli Lilly Laboratories, Janssen Pharmaceuticals; consultant for Auritec Laboratories, Molecular Insights Pharmaceuticals, Eli Lilly Laboratories, IFI, SpA, Janssen Pharmaceuticals, JDS Corporation, Organon Pharmaceuticals, Vertex Corporation; and is a research collaborator for Auritec Laboratories, Molecular Insights Pharmaceuticals. IPG and NBA have no reported conflict of interest.
Pediatric bipolar disorder: phenomenology and course of illness
Article first published online: 28 JUN 2004
Volume 6, Issue 4, pages 305–313, August 2004
How to Cite
Faedda, G. L., Baldessarini, R. J., Glovinsky, I. P. and Austin, N. B. (2004), Pediatric bipolar disorder: phenomenology and course of illness. Bipolar Disorders, 6: 305–313. doi: 10.1111/j.1399-5618.2004.00128.x
- Issue published online: 28 JUN 2004
- Article first published online: 28 JUN 2004
- Received 11 July 2003, revised and accepted for publication 30 April 2004
- bipolar disorder;
- pediatric psychiatry
Background: Specific features and diagnostic boundaries of childhood bipolar disorder (BD) remain controversial, and its differentiation from other disorders challenging, owing to high comorbidity with other common childhood disorders, and frequent lack of an episodic course typical of adult BD.
Methods: We repeatedly examined children meeting DSM-IV criteria for BD (excluding episode-duration requirements) and analyzed their clinical records to evaluate age-at-onset, family history, symptoms, course, and comorbidity.
Results: Of 82 juveniles (aged 10.6 ± 3.6 years) diagnosed with BD, 90% had a family history of mood or substance-use disorders, but only 10% of patients had been diagnosed with BD. In 74%, psychopathology was recognized before age 3, usually as mood and sleep disturbances, hyperactivity, aggression, and anxiety. At onset, dysphoric-manic and mixed presentations were most common (48%), euphoric mania less (35%), and depression least (17%). Subtype diagnoses were: BP-I (52%) > BP-II (40%) > cyclothymia (7%). DSM episode-duration criteria were met in 52% of cases, and frequent shifts of mood and energy were common.
Limitations: Partly retrospective study of clinically diagnosed referred outpatients without a comparison group.
Conclusions: Pediatric BD is often mis- or undiagnosed, although it often manifests with mood lability and sleep disturbances early in life. DSM BD criteria inconsistent with clinical findings require revision for pediatric application.