Covering confidence in bipolar diagnosis in children plus the need for educating the parents and bipolar child about all aspects of bipolar disorder.

Special issues concerning bipolar disorder in children

Although bipolar disorder has a low prevalence in childhood and adolescence, the diagnosis may be made in children as young as 5 years who meet DSM-IV TR criteria. The confidence of this diagnosis in early life may be increased if one or both parents also have bipolar disorder. In general, a more protracted and severe course of illness is associated with an early age of onset of bipolar disorder. Treatment with mood stabilizers is a vital part of maintaining optimal functioning in these youths. Also, the assessment of comorbid conditions is necessary, since comorbid conditions such as substance abuse or ADHD often may be present.

Educating Parents and the Bipolar Child

Education for parents and patients is an important aspect of treating an adolescent or child with bipolar disorder. The child or adolescent with bipolar disorder must be given the relevant facts in an age-appropriate and developmentally appropriate manner. The diagnosis, benefits of treatment, and detriment of treatment noncompliance should be made clear and understandable. Finally, the treatment team involved in the care of the child or teenager with bipolar and the family should be able to aid the patient and family in the understanding and management of bipolar disorder in their loved one.

Special Concerns:

• Personal caregivers and health care providers should not have false expectation that current mood may predict the safety of the patient or others in the future.

References:

• Geller B, Luby J: Child and adolescent bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1997 Sep; 36(9): 1168-76.
• Steiner H: Evaluation and management of violent behavior in bipolar adolescents. Symposium 19D. Presented at: The 153rd Annual Meeting of the American Psychiatric Association. May 14, 2000; Chicago.
• Tondo L, Baldessarini RJ, Hennen J, et al: Lithium treatment and risk of suicidal behavior in bipolar disorder patients. J Clin Psychiatry 1998 Aug; 59(8): 405-14.

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