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Abstract: 

There has been considerable controversy about the diagnosis of bipolar disorder in persons under the age of 18, especially in preadolescents. Regardless of whether the diagnosis of pre-pubertal children is appropriate or not, there is general agreement that youth diagnosed with bipolar disorder present with concerning behaviors and psychiatric symptoms. Although symptoms resembling mania and depression in children have been reported in case descriptions since the 1800s, the past 15 years have seen a dramatic increase in the rate of diagnosis of pediatric bipolar disorder. This increase in diagnosis has been met with controversy. Some have argued that it may be a rectification of a diagnostic system in which youth with bipolar disorder have been previously improperly diagnosed, whereas others have argued that the increase represents a misdiagnosis of children with other disorders or conditions. In one study, PBD was estimated to affect only 1% to 1.5% of children in the general adolescent population, yet children diagnosed with bipolar spectrum disorders make up between 17% and 30% of children in various psychiatric settings. Given the increased rate of the diagnosis of bipolar disorder in children and adolescents, a better understanding of the research regarding this group is warranted. This article examines the clinical presentation of youth diagnosed with bipolar disorder, to consider issues that arise with the diagnosis in youth, and to discuss current and future directions of the phenomenon of bipolar disorder in children.

Keywords: clinical presentation; rates of incidence; longitudinal outcomes of youth diagnosed with PBD; severe mood disorder; response to medication; psychosocial interventions; hypomanic episodes

Affiliations:  1: Clayton State University Department of Psychology; 2: Univ of Washington School of Medicine.