Pediatric bipolar disorder: Epidemiology, pathogenesis, clinical manifestations, and course
- Boris Birmaher, MD
Boris Birmaher, MD
- Endowed Chair in Early Onset Bipolar Disease, Professor of Psychiatry
- University of Pittsburgh, School of Medicine
Bipolar disorder in children and adolescents is characterized by recurrent episodes of elevated mood (mania or hypomania) which exceed what is expected for the child’s developmental stage and are not better accounted by other psychiatric and medical conditions. Youth with bipolar disorder usually have recurrent episodes of major depression. [1-3].
Bipolar disorder severely affects the normal development and psychosocial functioning of the youth and increases the risk for suicide, psychosis, substance abuse and behavioral, academic, social, and legal problems [1,2]. Youth with bipolar disorder frequently have a variable course with rapid fluctuation in mood symptoms during acute episodes. These factors, coupled with developmental issues influencing the clinical picture, the difficulties youth can have verbalizing their emotions, and high rates of comorbid disorders, account for the complexity and controversies in diagnosing children and adolescents with bipolar disorder.
This topic describes the epidemiology, pathophysiology, clinical presentation, and course of bipolar disorder in children and adolescents. The assessment and diagnosis of pediatric bipolar disorder are discussed separately, as are the epidemiology, clinical features, and diagnosis of bipolar disorder in adults.
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- Twin, adoption, and family studies
- Genetic studies
- Neuroimaging studies
- Psychosocial factors
- CLINICAL PRESENTATION
- - Grandiosity
- - Elation
- - Increased goal direction
- - Increased sexual activity
- Major depression
- Neurocognitive function
- - Psychiatric
- - General medical
- Youth at risk for bipolar disorder
- COURSE OF ILLNESS