The public health aspects of bipolar disorder in children and adolescents.

Bipolar disorder in children and adolescents is a major public health problem associated with significant functional impairment. Similar to adults with bipolar disorder, children and adolescents are at increased risk for substance-related disorders, weight problems, and impaired social support systems. Substance-related problems complicate treatment course. They often follow the onset of bipolar disorder; thus, the opportunity for prevention and/or early intervention exists. Evidence supports an association between mood disorders and weight gain. Psychotropic agents to treat bipolar disorder, particularly some second-generation antipsychotics, may be associated with weight gain. Obesity is associated with worse outcomes in bipolar disorder, so prevention of weight gain is clinically important. Environmental factors may contribute to relapse, so interventions to optimize social support systems are being evaluated. Pediatric bipolar disorder requires comprehensive management to achieve optimal outcome. Further research to study modifiable factors that contribute to its morbidity and chronicity is needed.