Outcomes for youths with early- and very-early-onset bipolar I disorder.

To examine differences between children and adolescents with bipolar I disorder in a public mental health system, medical records and computerized data files were reviewed for 82 newly admitted patients, focusing on documented diagnoses, clinical features, services and medications received, and psychosocial functioning changes over 18 months. Suicidality, violent or aggressive behavior, psychotic features, and severe/frequent mood changes were prevalent in 40-70% of the cohort, with children more likely to have comorbid attention deficit hyperactivity disorder and adolescents more likely to have substance-related problems. For clients who remained in treatment, functioning ratings improved over 18 months on multiple dimensions but were unrelated to type of service or pharmacotherapy received.