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Bipolar Disorder in Children and Adolescents

Published online by Cambridge University Press:  07 November 2014

Abstract

There is increased recognition that bipolar disorder has an early age of onset. The prevalence of bipolar disorder in prepubertal children has not been determined, however the prevalence in adolescence is ˜1%. Bipolar disorder in children poses a diagnostic challenge since the symptoms may differ from those in late adolescence and adulthood. Comorbid disorders, such as attention-deficit/hyperactivity disorder, further complicate both the diagnosis and course of the disorder. There is increasing evidence of the chronicity and severity of this disorder in youths. Bipolar disorder significantly disrupts a child's psychosocial development including impairments in academic functioning, family functioning, and relationship with peers. Although this disorder has significant morbidity in children and adolescents, there is a paucity of controlled studies to assess the efficacy and safety of mood stabilizers in the treatment of this disorder in youths. The treatment literature consists largely of case studies, retrospective chart reviews, and open-label studies. There is a compelling need for double-blind, placebo-controlled trials to determine whether commonly used medications to treat this disorder are significantly superior to placebo. Since many children in clinical practice require more than one psychotropic medication to adequately manage this disorder, studies of combination treatments are warranted. This review will provide an overview of the literature of bipolar disorder in children and adolescents, including discussion of the prevalence, diagnosis, epidemiology, course of the illness, and treatment issues.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Lewinsohn, PM, Klein, DN, Seeley, JR. Bipolar disorder during adolescence and young adulthood in a community sample. Bipolar Disord. 2000;2:281293.CrossRefGoogle Scholar
2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press: 1994.Google Scholar
3.Geller, B, Zimerman, B, Williams, M, et al.Diagnostic characteristics of 93 cases of prepubertal and early adolescent bipolar disorder phenotype by gender, puberty and comorbid attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 2000;10:157164.CrossRefGoogle ScholarPubMed
4.Carlson, GA, Bromet, EJ, Sievers, S. Phenomenology and outcome of subjects with early- and adult-onset psychotic mania. Am J Psychiatry. 2000;157:213219.CrossRefGoogle ScholarPubMed
5.Geller, B, Zimerman, B, Williams, M, et al.DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol 2002;12:1125.CrossRefGoogle Scholar
6.West, SA, Strakowski, SM, Sax, KW, McElroy, SL, Keck, PE Jr, McConville, BJ. Phenomenology and comorbidity of adolescents hospitalized for the treatment of acute mania. Biol Psychiatry. 1996;39:458460.CrossRefGoogle ScholarPubMed
7.Wozniak, J, Biederman, J, Mundy, E, et al.A pilot family study of childhood-onset mania. J Am Acad Child Adolesc Psychiatry. 1995;34:15771583.CrossRefGoogle ScholarPubMed
8.Kennah, A, Birmaher, B, Brent, D, et al. Is bipolar disorder specifically associated with panic disorder in youth? Paper presented at: Annual Meeting of the American Academy of Child and Adolescent Psychiatry. 10 24-29,2000; New York, NY.Google Scholar
9.Kovacs, M, Pollock, M. Bipolar disorder and comorbid conduct disorder in childhood and adolescence. J Am Acad Child Adolesc Psychiatry. 1995;34:715723.Google ScholarPubMed
10.Geller, B, Zimerman, B, Williams, M, et al.Bipolar disorder at prospective follow-up of adults who had prepubertal major depressive disorder. Am J Psychiatry. 2001;158:125127.CrossRefGoogle ScholarPubMed
11.Geller, B, Fox, LW, Clark, KA. Rate and predictors of prepubertal bipolarity during follow-up of 6- to 12-year-old depressed children. J Am Acad Child Adolesc Psychiatry. 1994;33:461468.CrossRefGoogle ScholarPubMed
12.Straber, M, Lampert, B, Schmidt, S, et al.The course of major depressive disorder in adolescents: I. Recovery and risk of manic switching in a follow-up of psychotic and nonpsychotic subtypes. J Am Acad Child Adolesc Psychiatry. 1993;32:3442.CrossRefGoogle Scholar
13.Chang, KD, Steiner, H, Ketter, TA. Psychiatrie phenomenology of child and-adolescent bipolar offspring. J Am Acad Child Adolesc Psychiatry. 2000;39:453460.CrossRefGoogle ScholarPubMed
14.Geller, B, Craney, JL, Bolhofner, K, et al.Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar disorder phenotype. Am J Psychiatry. 2002;159:927933.CrossRefGoogle ScholarPubMed
15.Straber, M, Schmidtlackner, S, Freeman, R, et al.Recovery and Relapse in Adolescents with Bipolar Affective-Illness: a five-year naturalistic, prospective follow-up. J Am Acad Child Adolesc Psychiatry. 1995;34:724731.CrossRefGoogle Scholar
16.Lewinsohn, PM, Klein, DN, Seeley, JR. Bipolar disorder during adolescence and young adulthood in a community sample. Bipolar Disord. 2000;2:281293.CrossRefGoogle Scholar
17.Wagner, KD. Management of bipolar disorder in children and adolescents. Psychopharmacol Bull. 2002;36:151159.Google ScholarPubMed
18.Geller, B, Cooper, TB, Sun, K, et al.Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry. 1998;37:171178.CrossRefGoogle ScholarPubMed
19.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. rev. Washington, DC: American Psychiatric Press; 1987.Google Scholar
20.Kafantaris, V, Coletti, DJ, Dicker, R, et al.Adjunctive antipsychotic treatment of adolescents with bipolar psychosis. J Am Acad Child Adolesc Psychiatry. 2001;40:1448–56.CrossRefGoogle ScholarPubMed
21.Hagino, OR, Weller, EB, Weller, RA, et al.Untoward effects of lithium treatment in children aged four through six years. J Am Acad Child Adolesc Psychiatry. 1995;34:15841590.CrossRefGoogle ScholarPubMed
22.Wagner, KD, Weller, E, Carlson, G, et al.An open-label trial of divalproex in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2002;41:12241230.CrossRefGoogle ScholarPubMed
23.Kowatch, RA, Suppes, T, Carmody, TJ, et al.Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2000;39:713720.CrossRefGoogle ScholarPubMed
24.Kowatch, RA, Carmody, TJ, Suppes, T, et al.Acute and continuation pharmacological treatment of children and adolescents with bipolar disorders: a summary of two previous studies. Acta Neuropsychiatrica. 2000;12:145149.Google ScholarPubMed
25.Isojarvi, JI, Laatikainen, TJ, Pakarinen, AJ, et al.Poylcystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med. 1993;4;329:13831388.CrossRefGoogle Scholar
26.Isojarvi, JI, Laatikainen, TJ, Knif, M, et al.Obesity and endocrine disorders in women taking valproate for epilepsy. Ann Neurol. 1996;39:579584.CrossRefGoogle ScholarPubMed
27.Rasgon, NL, Altshuler, LL, Gudeman, D, et al.Medication status and polycystic ovary syndrome in women with bipolar disorder: a preliminary report. J Clin Psychiatry. 2000;61:173178.CrossRefGoogle ScholarPubMed
28.Kowatch, RA, Carmody, TJ, Suppes, T, et al.Acute and continuation pharmacological treatment of children and adolescents with bipolar disorders: a summary of two previous studies. Acta Neuropsychiatrica. 2000;12:145149.CrossRefGoogle ScholarPubMed
29.Davanzo, PA, McCracken, JT. Mood stabilizers in the treatment of juvenile bipolar disorder. Advances and controversies. Child Adolesc Psychiatr Clin N Am. 2000;9:159182.CrossRefGoogle ScholarPubMed
30.Frazier, JA, Biederman, J, Tohen, M, et al.A prospective open-label treatment trial of olanzapine monotherapy in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol. 2001;11:239250.CrossRefGoogle ScholarPubMed
31.Frazier, JA, Meyer, MC, Biederman, J, et al.Risperidone treatment for juvenile bipolar disorder: a retrospective chart review. J Am Acad Child Adolesc Psychiatry. 1999;38:960965.CrossRefGoogle ScholarPubMed
32.Delbello, MP, Schwiers, ML, Rosenberg, HL, et al.A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J Am Acad Child Adolesc Psychiatry. 2002;41:12161223.CrossRefGoogle ScholarPubMed
33.Ryback, RS, Brodasky, L, Munasifi, F. Gabapentin in bipolar disorder. J Neuropsychiatry Clin Neurosci. 1997;9:301.CrossRefGoogle ScholarPubMed
34.Delbello, M, Kowatch, RA, Warner, J, et al. Topiramate use for pediatric bipolar disorder: a retrospective chart review. Poster session presented at: Annual Meeting of the Institute of Psychiatric Service; 10 11, 2001; Orlando, FL.Google Scholar
35.Kusumakar, V, Yatham, LN. An open study of lamotrigine in refractory bipolar depression. Psychiatry Res. 1997;72:145148.CrossRefGoogle ScholarPubMed
36.Gilman, JT. Lamotrigine: An antiepileptic agent for the treatment of partial seizures. Ann Pharmacother. 1995;29:144151.CrossRefGoogle ScholarPubMed
37.Reimherr, JP, Rosen, SJ, Leahy, LF. Oxcarbazepine treatment in child and adolescent mood and anxiety disorders. Paper presented at: Annual Meeting of the United States Psychiatric Congress; 10 28-31,2002; Las Vegas, NV.Google Scholar
38.Masi, G, Mucci, M, Millepiede, S. Clozapine in adolescent inpatients with acute mania. J Child Adolesc Psychopharmacol. 2002;12:9399.CrossRefGoogle ScholarPubMed
39.Rey, JM, Walter, G. Half a century of ECt use in young people. Am J Psychiatry. 1997;154:595602.Google ScholarPubMed
40.Taieb, O, Flament, MF, Chevret, S, et al.Clinical relevance of electro-convulsive therapy (ECT) in adolescents with severe mood disorder: evidence from a follow-up study. Eur Psychiatry. 2002;17:206212.CrossRefGoogle Scholar