The diagnosis of bipolar disorder in children and adolescents has increased in clinical settings throughout the last two decades. Its prevalence is around 1.8% being similar in different countries. However, how it is diagnosed is still a challenge due to its variability of clinical presentations, overlapping with other more commonly psychiatric disorders and high rates of comorbidities. Therefore, it is still important to report cases in order to enhance our knowledge about this complex field of the mental health in childhood and adolescence.

To present clinical characteristics and follow-up of a 12 year-old adolescent who met DSM-IV criteria for bipolar disorder NOS.

To describe the clinical trajectory from the diagnosis to the outcomes of the mentioned case, focusing on the main symptoms and family functioning.

The combination of mood stabilizers, family interventions and individual psychodynamic therapy resulted in an improvement of the global functioning.

Even in a complex case of child bipolar disorder with early onset the treatment based on pharmacotherapy, individual psychodynamic therapy and systemic family therapy was able to provide satisfactory results.