Benjamin I Goldstein1, Boris Birmaher. 1. Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, Canada Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburg, Pennsylvania, U.S.A.
Abstract
BACKGROUND: Over the past 20 years, the evidence regarding pediatric bipolar disorder (BP) has increased substantially. As a result, recent concerns have focused primarily on prevalence and differential diagnosis. METHOD: Selective review of the literature. RESULTS: BP as defined by rigorously applying diagnostic criteria has been observed among children and especially adolescents in numerous countries. In contrast to increasing diagnoses in clinical settings, prevalence in epidemiologic studies has not recently changed. BPspectrum conditions among youth are highly impairing and confer high risk for conversion to BP-I and BP-II. Compared to adults, youth with BP have more mixed symptoms, more changes in mood polarity, are more often symptomatic and seem to have worse prognosis. The course, clinical characteristics, and comorbidities of BP among children and adolescents are in many ways otherwise similar to those of adults with BP. Nonetheless, many youth with BP receive no treatment and most do not receive BP-specific treatment. CONCLUSION: Despite increased evidence supporting the validity of pediatric BP, discrepancies between clinical and epidemiologic findings suggest that diagnostic misapplication may be common. Simultaneously, low rates of treatment of youth with BP suggest that withholding of BP diagnoses may also be common. Clinicians should apply diagnostic criteria rigorously in order to optimize diagnostic accuracy and ensure appropriate treatment.
BACKGROUND: Over the past 20 years, the evidence regarding pediatric bipolar disorder (BP) has increased substantially. As a result, recent concerns have focused primarily on prevalence and differential diagnosis. METHOD: Selective review of the literature. RESULTS: BP as defined by rigorously applying diagnostic criteria has been observed among children and especially adolescents in numerous countries. In contrast to increasing diagnoses in clinical settings, prevalence in epidemiologic studies has not recently changed. BPspectrum conditions among youth are highly impairing and confer high risk for conversion to BP-I and BP-II. Compared to adults, youth with BP have more mixed symptoms, more changes in mood polarity, are more often symptomatic and seem to have worse prognosis. The course, clinical characteristics, and comorbidities of BP among children and adolescents are in many ways otherwise similar to those of adults with BP. Nonetheless, many youth with BP receive no treatment and most do not receive BP-specific treatment. CONCLUSION: Despite increased evidence supporting the validity of pediatric BP, discrepancies between clinical and epidemiologic findings suggest that diagnostic misapplication may be common. Simultaneously, low rates of treatment of youth with BP suggest that withholding of BP diagnoses may also be common. Clinicians should apply diagnostic criteria rigorously in order to optimize diagnostic accuracy and ensure appropriate treatment.
Authors: David A Axelson; Boris Birmaher; Michael A Strober; Benjamin I Goldstein; Wonho Ha; Mary Kay Gill; Tina R Goldstein; Shirley Yen; Heather Hower; Jeffrey I Hunt; Fangzi Liao; Satish Iyengar; Daniel Dickstein; Eunice Kim; Neal D Ryan; Erica Frankel; Martin B Keller Journal: J Am Acad Child Adolesc Psychiatry Date: 2011-09-08 Impact factor: 8.829
Authors: Brendan A Rich; Mariana Schmajuk; Koraly E Perez-Edgar; Nathan A Fox; Daniel S Pine; Ellen Leibenluft Journal: Am J Psychiatry Date: 2007-02 Impact factor: 18.112
Authors: Benjamin I Goldstein; Wael Shamseddeen; David A Axelson; Cathy Kalas; Kelly Monk; David A Brent; David J Kupfer; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2010-04 Impact factor: 8.829
Authors: Kirsi Suominen; Outi Mantere; Hanna Valtonen; Petri Arvilommi; Sami Leppämäki; Tiina Paunio; Erkki Isometsä Journal: Bipolar Disord Date: 2007-11 Impact factor: 6.744
Authors: Lakshmi N Yatham; Sidney H Kennedy; Sagar V Parikh; Ayal Schaffer; David J Bond; Benicio N Frey; Verinder Sharma; Benjamin I Goldstein; Soham Rej; Serge Beaulieu; Martin Alda; Glenda MacQueen; Roumen V Milev; Arun Ravindran; Claire O'Donovan; Diane McIntosh; Raymond W Lam; Gustavo Vazquez; Flavio Kapczinski; Roger S McIntyre; Jan Kozicky; Shigenobu Kanba; Beny Lafer; Trisha Suppes; Joseph R Calabrese; Eduard Vieta; Gin Malhi; Robert M Post; Michael Berk Journal: Bipolar Disord Date: 2018-03-14 Impact factor: 6.744
Authors: Joseph Biederman; Janet Wozniak; Laura Tarko; Giulia Serra; Mariely Hernandez; Katie McDermott; K Yvonne Woodsworth; Mai Uchida; Stephen V Faraone Journal: J Affect Disord Date: 2013-10-07 Impact factor: 4.839
Authors: Henrique M Fernandes; Joana Cabral; Tim J van Hartevelt; Louis-David Lord; Carsten Gleesborg; Arne Møller; Gustavo Deco; Peter C Whybrow; Predrag Petrovic; Anthony C James; Morten L Kringelbach Journal: Sci Rep Date: 2019-09-20 Impact factor: 4.379