Pediatric Bipolar Disorder Comes of Age

Leibenluft, Ellen

doi:10.1001/archpsyc.65.10.1122

Cited by 20 publications

(10 citation statements)

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“…Pediatric bipolar disorder (PBD) (occurring prior to age 18) is a developmental brain disorder that is among the most severe and disabling psychiatric conditions affecting youth (1–4). Untreated bipolar disorder (BD), particularly during formative developmental years may be one of the causes of the significant morbidity and mortality seen with this disorder; therefore, early diagnosis and early-intervention may prevent the later sequelae of the illness (5, 6).…”

Section: Introductionmentioning

confidence: 99%

Abnormal Functional Connectivity Between Default and Salience Networks in Pediatric Bipolar Disorder

Lopez-Larson

Shah

Weeks

et al. 2017

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Section: Introductionmentioning

confidence: 99%

Abnormal Functional Connectivity Between Default and Salience Networks in Pediatric Bipolar Disorder

Lopez-Larson

Shah

Weeks

et al. 2017

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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“…The past decade has seen a dramatic increase in focus on pediatric bipolar disorder as the number of children receiving the diagnosis has escalated (1–3). Discussion has centered on the diagnostic boundaries of bipolar disorder in children as compared with adults.…”

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confidence: 99%

Severe Mood Dysregulation, Irritability, and the Diagnostic Boundaries of Bipolar Disorder in Youths

Leibenluft¹

2011

AJP

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493

410

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In recent years, increasing numbers of children have been diagnosed with bipolar disorder. In some cases, children with unstable mood clearly meet current diagnostic criteria for bipolar disorder, and in others, the diagnosis is unclear. Severe mood dysregulation is a syndrome defined to capture the symptomatology of children whose diagnostic status with respect to bipolar disorder is uncertain, that is, those who have severe, nonepisodic irritability and the hyperarousal symptoms characteristic of mania but who lack the well-demarcated periods of elevated or irritable mood characteristic of bipolar disorder. Levels of impairment are comparable between youths with bipolar disorder and those with severe mood dysregulation. An emerging literature compares children with severe mood dysregulation and those with bipolar disorder in longitudinal course, family history, and pathophysiology. Longitudinal data in both clinical and community samples indicate that nonepisodic irritability in youths is common and is associated with an elevated risk for anxiety and unipolar depressive disorders, but not bipolar disorder, in adulthood. Data also suggest that youths with severe mood dysregulation have lower familial rates of bipolar disorder than do those with bipolar disorder. While youths in both patient groups have deficits in face emotion labeling and experience more frustration than do normally developing children, the brain mechanisms mediating these pathophysiologic abnormalities appear to differ between the two patient groups. No specific treatment for severe mood dysregulation currently exists, but verification of its identity as a syndrome distinct from bipolar disorder by further research should include treatment trials.

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“…Overall, clinically, mood disorders in this age group present with the same core features manifested in adults and they can be diagnosed on the basis of operationalized criteria (Leibenluft 2008 ). However, the presence of some age-specifi c features should be noted.…”

Section: Clinical Features Of Paediatric Bdmentioning

confidence: 90%

Special Issues

Fountoulakis¹

2014

Bipolar Disorder

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It is well known that concerning the prevalence of unipolar depression, females have almost double rates in comparison to males (Lloyd and Miller 1997 ;Blazer et al. 1994 ). However, this does not hold true concerning BD, for which similar rates between males and females are reported. There are some data suggesting that males might be over-represented in those diagnosed with a BD-I and females overrepresented in those diagnosed with a BD-II disorder (Parker et al. 2014 ).Some authors suggest that females with less social support and experiencing social stressors might be at the greatest risk to develop depression, but this concerns unipolar and not bipolar cases. It has been documented that women are more likely to experience stressful and even threatening life events and are at a higher risk of early sexual abuse and current spousal abuse (Roesler and McKenzie 1994 ;Finkelhor et al. 1990 ). Women also might use oral contraceptive and often experience mood disorders temporally related to their gender identity (e.g. premenstrualor postpartum-onset mood disorders) which might have an impact on the course of BD (Meinhard et al. 2014 ). A number of adverse experiences related to sexual life and determined by gender seem to happen in the lives of bipolar women. In comparison to healthy women, bipolar women might be more likely to have been forced by their partners to have sex, raped or suffering from sexually transmitted diseases. The use of contraceptives is usually sporadic and their rates of pregnancy and abortion are high (Ozcan et al. 2014 ).Also, in almost all societies, unequal roles for women are in place, and additionally there is a gender difference in copying styles; men might react to emotional distress by trying not to think about it, while women are more likely to ruminate over their problems (Nolen-Hoeksema and Girgus 1994 ;Nolen-Hoeksema et al. 1999, 2007. In this frame, women are more likely to report depressive symptoms due to marital problems than men (Joiner et al. 1992 ;Hammen and Peters 1978 ) and are more likely to be diagnosed with depression because they seek professional help more often for their depressive symptoms and maybe because they are more 660 sensitive to negative relationships (Phillips and Segal 1969 ). Concerning the neurocognitive function, the data are inconsistent (Bucker et al. 2014 ;Suwalska and Lojko 2014 ).Overall there does not seem to be any signifi cant gender difference concerning the risk of recurrence, thus suggesting that gender is among the risk factors for initiating depressive symptoms in unipolar depression but not among those determining the course and outcome either in unipolar or in bipolar cases (Nazroo et al. 1997 ;Philibert et al. 1997 ).There are a number of comorbid conditions which seem to be more frequent in bipolar women, including abdominal obesity. This happens possibly because of a higher frequency of predominant depressive polarity in women and more seasonal variations in mood disturbance and reproductive life events and related treatments (Baskara...

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Pediatric Bipolar Disorder Comes of Age

Cited by 20 publications

References 32 publications

Abnormal Functional Connectivity Between Default and Salience Networks in Pediatric Bipolar Disorder

Abnormal Functional Connectivity Between Default and Salience Networks in Pediatric Bipolar Disorder

Severe Mood Dysregulation, Irritability, and the Diagnostic Boundaries of Bipolar Disorder in Youths

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