Course information

The number of children and adolescents receiving a diagnosis of bipolar disorder has increased markedly during the past decade in the United States. Bipolar disorder was once thought to occur only rarely in youths, especially children. However, there has been a shift in how the disorder is defined in juveniles. There are also similar debates about how broadly to define the disorder in adults. In general, the field has shifted from diagnostic practices based on pattern recognition or template (i.e., the syndrome is defined by characteristic patterns of symptom and clinical presentations, including an episodic course) to one in which individual symptom criteria are considered as evidence of the disorder. Inasmuch, more individuals, children and adults, are characterized as having subthreshold or B atypical cases based on periods of elated, expansive, or irritable mood. This atypical but common presentation of mania in children appears to be caused by developmental differences in manic symptom expression and the evolving picture of this disorder in children. Due to the increase in diagnosis of bipolar disorder and the controversies surrounding diagnosis and treatment, child and adolescent psychiatrists and allied health professionals need to know whether different approaches lead to different ways of addressing treatment of mania and bipolar depression.

Gabrielle A. Carlson, M.D., Chair, Professor of Psychiatry and Pediatrics, Director, Child and Adolescent Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY