Child and Adolescent Bipolar Disorder: A Review of the Past 10 Years

Decreased Anterior Cingulate Myo-inositol/Creatine Spectroscopy Resonance with Lithium Treatment in Children with Bipolar Disorder

“…A lack of clear definitions regarding the severity and characteristics of classic mania as it applies to children has contributed to the blurring of diagnostic boundaries in early onset BPD. Nevertheless, the somewhat atypical clinical presentation of juvenile-onset BPD, including extreme hyperactivity, moodiness, chronic rather than episodic irritability and prolonged temper tantrums (Geller and Luby 1997), alternating with depressive symptoms and difficulty sleeping at night (Weller et al 1995), differentiates children diagnosed with BPD in our sample from children with ADHD (Biederman et al 1996). Although some of these NEUROPSYCHOPHARMACOLOGY 2001-VOL.…”

“…A lack of clear definitions regarding the severity and characteristics of classic mania as it applies to children has contributed to the blurring of diagnostic boundaries in early onset BPD. Nevertheless, the somewhat atypical clinical presentation of juvenile-onset BPD, including extreme hyperactivity, moodiness, chronic rather than episodic irritability and prolonged temper tantrums (Geller and Luby 1997), alternating with depressive symptoms and difficulty sleeping at night (Weller et al 1995), differentiates children diagnosed with BPD in our sample from children with ADHD (Biederman et al 1996). Although some of these symptoms-hyperactivity, distractibility, impulsive risk taking-prevail in both BPD and ADHD, testing with standard screening rating scales also show that delinquent and aggressive behavior, somatic complaints, anxiety/depression, and thought problems are far more severe in children with BPD than ADHD (Biederman et al 1995).…”

“…4 magnetic resonance of myo-inositol in the anterior cingulate cortex in children with BPD, as measured by in vivo proton magnetic resonance spectroscopy ( 1 H MRS). Secondarily, we postulated that a decrease in myo-inositol signal in response to lithium might be a predictor of treatment efficacy.Lithium has traditionally been the preferred treatment of the manic phase of bipolar illness in adults, children (Geller and Luby 1997), and adolescents (Strober et al 1995) with BPD. Open-label (Hsu 1986;Carlson et al 1992;Strober et al 1995), and one doubleblind placebo-controlled study of adolescents with substance abuse and mania (Geller et al 1998) suggest that juveniles with BPD may have somewhat reduced benefit from acute lithium therapy compared with adults.…”

“…Open-label (Hsu 1986;Carlson et al 1992;Strober et al 1995), and one doubleblind placebo-controlled study of adolescents with substance abuse and mania (Geller et al 1998) suggest that juveniles with BPD may have somewhat reduced benefit from acute lithium therapy compared with adults. Nevertheless, lithium continues to be widely prescribed among children and adolescents with BPD (Geller and Luby 1997) as well as for young patients presenting with excessive irritability (Fava 1997) and extreme affective dysregulation (Vitiello and Stoff 1997).…”

Clinical features of body dysmorphic disorder in adolescents and adults

“…This question is important because psychopathology may meaningfully differ in these age groups. The clinical features of other psychiatric disorders, such as depression, bipolar disorder, obsessive-compulsive disorder, and attention deficit hyperactivity disorder, have been shown to vary in children/adolescents and adults (e.g., Carlson and Kashani, 1988;Dulcan, 1997;Geller and Luby, 1997;Geller et al, 2001). Demonstrating differences-as well as similaritiesin these age groups has important clinical implications.…”