Citation

Santosh PJ, Canagaratnam M. Psychiatry 2008; 7(8): 349-352.

Copyright

(Copyright © 2008, Medicine Publishing Company Ltd.)

DOI

10.1016/j.mppsy.2008.06.002

PMID

unavailable

Abstract

The diagnosis of paediatric bipolar disorder (PBD) polarizes views, and many question its existence as it differs in presentation from typical adult bipolar disorder. Debate surrounds the applicability of elation and episodicity as essential features in children. The 'narrow phenotype' that insists on both elation and episodicity has greater support in being PBD, compared with the 'broader phenotype' defined by chronic irritability and explosive rage. Few children meet criteria for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, bipolar I and II, but bipolar not otherwise specified is frequently diagnosed. A theoretical, conceptual PBD spectrum model that accommodates the current viewpoints is provided in this article. Diagnosis should be made by a specialist in child and adolescent mental health, assisted by prospective mood charting, and symptoms should be evaluated against age expected norms, temperament, and considered in their context. Despite disagreements regarding the appropriate label, treating severe and impairing affective dysregulation remains crucial. Treatment of PBD should essentially combine pharmacological and psychosocial interventions. Crown Copyright © 2008.

Language: en

Keywords

adolescent; human; suicide; child; assessment; autism; bipolar disorder; depression; sex difference; social support; psychosis; suicide attempt; major depression; lithium; comorbidity; disease severity; mood disorder; review; substance abuse; mental disease; clinical practice; anticonvulsive agent; antidepressant agent; mental health care; neuroleptic agent; personality disorder; differential diagnosis; child psychiatry; psychologic assessment; amfebutamone; fluoxetine; pathophysiology; priority journal; quetiapine; anxiety disorder; childhood disease; practice guideline; coping behavior; electroconvulsive therapy; steroid; psychopharmacotherapy; family history; psychiatric diagnosis; psychosocial care; carbamazepine; olanzapine; risperidone; weight gain; agranulocytosis; benzodiazepine; hyperprolactinemia; onset age; hypercholesterolemia; valproic acid; mania; bipolar I disorder; bipolar II disorder; gabapentin; lamotrigine; side effect; symptom; attention deficit disorder; atypical antipsychotic agent; antibiotic agent; low drug dose; psychostimulant agent; tranquilizer; drug indication; teratogenicity; hyperglycemia; diagnostic and statistical manual of mental disorders; aplastic anemia; Stevens Johnson syndrome; aripiprazole; mood stabilizer; hyperactivity; ovary polycystic disease; rapid cycling bipolar disorder; drug dose escalation; paediatric