Bipolar disorder in children and adolescents

Boris Birmaher; David Axelson

doi:10.1017/CBO9780511544019.011

10 - Bipolar disorder in children and adolescents

Published online by Cambridge University Press: 10 August 2009

Boris Birmaher and

David Axelson

Edited by

Andreas Marneros and

Frederick Goodwin

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Boris Birmaher: Affiliation:
University of Pittsburgh Medical Center Pittsburgh PA USA
David Axelson: Affiliation:
University of Pittsburgh Medical Center Pittsburgh PA USA
Andreas Marneros: Affiliation:
Martin Luther-Universität Halle-Wittenburg, Germany
Frederick Goodwin: Affiliation:
George Washington University, Washington DC

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Summary

Introduction

There is no doubt that children and adolescents may experience classical Kraepelinian (1921) or Diagnostic and Statistical Manual of Mental Disorders (DSM)-type bipolar disorder (BP-I, II, mixed, rapid-cycling; American Psychiatric Association, 1994). However, as discussed in detail below, many BP children and adolescents have very short and frequent periods of mania, hypomania, or depression and, more controversially, some have continuous mood lability and irritability (Nottelman et al., 2001). Children and adolescents with BP disorder usually have poor psychosocial outcome, increased risk for suicide, substance abuse, and psychosis (Lewinsohn et al., 1995, 2000; Strober et al., 1995; Geller et al., 1998a, 1998b, 2000a, b, 2001; Birmaher, 2001), indicating the need for accurate diagnosis and prompt treatment of this illness.

Since the research on BP disorder in children and adolescents is in its earlier stages, below we present the extant literature following in most part the criteria described by Robins and Guze (1970) to validate a psychiatric disorder, including the presence of a reliable diagnosis that can be differentiated from other psychiatric disorders, specific course, family history, response to treatment, and biological characteristics. Because of their scarcity, no biological studies are presented in this chapter.

Prevalence

A large adolescent community study, using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (6–18) epidemiologic version (K-SADS) (Chambers et al., 1985), found that, similar to adult epidemiological studies, DSM-IV bipolar disorder was approximately 1% (Lewinsohn et al., 1995). However, most adolescents had BP-II (periods of major depression and hypomania) and cyclothymic disorders.

Keywords

adolescents bipolar disorder children DSM-IV rapid cycles Kraepelinian mood stabilizers

Type: Chapter
Information: Bipolar Disorders
Mixed States, Rapid Cycling and Atypical Forms
, pp. 237 - 251

DOI: https://doi.org/10.1017/CBO9780511544019.011 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2005

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10 - Bipolar disorder in children and adolescents

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