Abstract
Despite ongoing controversy, the view that pediatric mania is rare or nonexistent
has been increasingly challenged not only by case reports, but also by systematic
research. This research strongly suggests that pediatric mania may not be rare but
that it may be difficult to diagnose. Since children with mania are likely to become
adults with bipolar disorder, the recognition and characterization of childhood-onset
mania may help identify a meaningful developmental subtype of bipolar disorder worthy
of further investigation. The major difficulties that complicate the diagnosis of
pediatric mania include: 1) its pattern of comorbidity may be unique by adult standards,
especially its overlap with attention-deficit/hyperactivity disorder, aggression,
and conduct disorder; 2) its overlap with substance use disorders; 3) its association
with trauma and adversity; and 4) its response to treatment is atypical by adult standards.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Manual for the Child Behavior Checklist/4-18 and 1991 Profile. University of Vermont, Department of Psychiatry, Burlington1991
- The Child Behavior Checklist. University Associates in Psychiatry, Burlington1983
- Affective disorders in referred children and younger siblings of manic-depressives.Arch Gen Psychiatry. 1985; 42: 996-1003
- Depressive comorbidity in children and adolescents.Am J Psychiatry. 1993; 150: 1779-1791
- The “atypical” picture of adolescent mania.Am J Psychiatry. 1982; 139: 602-606
- Resolved.J Am Acad Child Adolesc Psychiatry. 1998; 37: 1091-1093
- Conduct disorder with and without mania in a referred sample of ADHD children.J Affect Disord. 1997; 44: 177-188
- Further evidence of a bidirectional overlap between juvenile mania and conduct disorder in children.J Am Acad Child Adolesc Psychiatry. 1999; 38: 468-476
- Panic disorder and agoraphobia in consecutively referred children and adolescents.J Am Acad Child Adolesc Psychiatry. 1997; 36: 214-223
- Attention deficit hyperactivity disorder and juvenile mania.J Am Acad Child Adolesc Psychiatry. 1996; 35: 997-1008
- The naturalistic course of pharmacologic treatment of children with manic-like symptoms.J Clin Psychiatry. 1998; 59: 628-637
- Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study.J Am Acad Child Adolesc Psychiatry. 1997; 36: 21-29
- CBCL clinical scales discriminate prepubertal children with structured-interview derived diagnosis of mania from those with ADHD.J Am Acad Child Adolesc Psychiatry. 1995; 34: 464-471
- Comorbid disorders in hospitalized bipolar adolescents compared with unipolar depressed adolescents.Child Psychiatry Hum Dev. 1995; 26: 11-18
- Mood swings in patients with panic disorder.Can J Psychiatry. 1994; 39: 91-94
- Lithium in hospitalized aggressive children with conduct disorder.J Am Acad Child Adolesc Psychiatry. 1995; 34: 445-453
- Behavioral efficacy of haloperidol and lithium carbonate.Arch Gen Psychiatry. 1984; 41: 650-656
- Manic symptoms in psychiatrically hospitalized children—what do they mean?.J Affect Disord. 1998; 51: 123-135
- Bipolar affective disorders in childhood and adolescence.in: Cantwell D.P. Carlson G.A. Affective Disorders in Childhood and Adolescence. Spectrum, New York1983: 61-83
- Classification issues of bipolar disorders in childhood.Psychiatr Dev. 1984; 2: 273-285
- Phenomenology and outcome of subjects with early- and adult-onset psychotic mania.Am J Psychiatry. 2000; 157: 213-219
Carlson GA, Jensen PS, Nottelmann ED (1998): Current issues in childhood bipolarity. J Affect Disord 51(2).
- Psychiatric phenomenology of child and adolescetn bipolar offspring.J Am Acad Child Adolesc Psychiatry. 2000; 39: 453-460
- Comorbidity of panic disorder in bipolar illness.Am J Psychiatry. 1995; 152: 280-283
- Carbamazepine in aggressive children with conduct disorder.J Am Acad Child Adolesc Psychiatry. 1996; 35: 480-490
- Manic-depressive variant syndrome of childhood.Am J Psychiatry. 1979; 136: 702-706
- Long-term experience with lithium treatment in childhood.J Am Acad Child Adolesc Psychiatry. 1987; 26: 389-394
- Lithium-induced behavior changes in children with symptoms suggesting manic-depressive illness.Psychopharmacol Bull. 1983; 19: 258-265
- Pediatric-onset bipolar disorder.Harvard Rev Psychiatry. 1995; 3: 171-195
- Bipolar and antisocial disorders among relatives of ADHD children.Neuropsychiatr Genet. 1998; 81: 108-116
Faraone SV, Biederman J, Monuteaux MC (in press): Attention deficit hyperactivity disorder with bipolar disorder in girls: Further evidence for a familial subtype? J Affect Disord.
- Is comorbidity with ADHD a marker for juvenile onset mania?.J Am Acad Child Adolesc Psychiatry. 1997; 36: 1046-1055
- Genetics and Mental Disorders. Guilford, New York1999
- Methods in psychiatric genetics.in: Tohen M. Tsuang M.T. Zahner G.E.P. Textbook in Psychiatric Epidemiology. Wiley, New York1995: 81-134
- Juvenile manic-depressive illness.J Am Acad Child Adolesc Psychiatry. 1973; 12: 123-136
- A double-blind pilot study of risperidone in the treatment of conduct disorder.J Am Acad Child Adolesc Psychiatry. 2000; 39: 509-516
Frazier J, Biederman J, Wilens T, Spencer T (1999a, October): Advanced issues in psychopharmacology: Psychotic disorders and bipolar disorders in children and adolescents. Presented at the 46th annual meeting of the American Academy of Child and Adolescent Psychiatry, Chicago.
- Risperidone treatment for juvenile bipolar disorder.J Am Acad Child Adolesc Psychiatry. 1999; 38: 960-965
- Rate and predictors of prepubertal bipolarity during follow-up of 6-to 12-year-old depressed children.J Am Acad Child Adolesc Psychiatry. 1994; 33: 461-468
- Child and adolescent bipolar disorder.J Am Acad Child Adolesc Psychiatry. 1997; 36: 1168-1176
- Complex and rapid-cycling in bipolar children and adolescents.J Affect Disord. 1995; 34: 259-268
- Prepubertal and young adolescent bipolarity versus ADHD.J Affect Disord. 1998; 51: 93-100
- Confirmation that Child Behavior Checklist clinical scales discriminate juvenile mania from attention deficit hyperactivity disorder.J Paediatr Child Health. 1999; 35: 199-203
- Post-traumatic stress disorder in the general population.N Engl J Med. 1987; 317: 1630-1634
- The millennium of mind, brain, and behavior.Arch Gen Psychiatry. 2000; 57: 88-89
- Posttraumatic stress disorder in the national comorbidity survey.Arch Gen Psychiatry. 1995; 52: 1048-1060
- The self-medication hypothesis of substance use disorders.Harvard Rev Psychiatry. 1997; 4: 231-244
- Resolved.J Am Acad Child Adolesc Psychiatry. 1998; 37: 1093-1095
- Bipolar disorder and comorbid conduct disorder in childhood and adolescence.J Am Acad Child Adolesc Psychiatry. 1995; 34: 715-723
- Relationship between psychiatric illness and conduct disorder in adolescents.Can J Psychiatry. 1989; 34: 526-529
- Clinical and research implications of the diagnosis of dysphoric or mixed mania or hypomania.Am J Psychiatry. 1992; 149: 1633-1644
- Adolescent versus adult onset of mania.Am J Psychiatry. 1988; 145: 221-223
- Attention Deficit Hyperactivity Disorder and comorbid disorders.Am J Psychiatry. 1995; 152: 1793-1800
Nottelmann ED (1995): Bipolar affective disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry 34(6).
- Bipolar spectrum disorders in patients diagnosed with velo-cardio-facial syndrome.Am J Psychiatry. 1996; 153: 1541-1547
- Comorbidity of attention deficit hyperactivity disorder with early- and late-onset bipolar disorder.Am J Psychiatry. 2000; 157: 466-468
- Relevance of early age-of-onset in genetic studies of bipolar affective disorder.J Am Acad Child Adolesc Psychiatry. 1992; 31: 606-610
- Bipolar illness in adolescents with major depression.Arch Gen Psychiatry. 1982; 39: 549-555
- A family study of bipolar I disorder in adolescence.J Affect Disord. 1988; 15: 255-268
- Relapse following discontinuation of lithium maintenance therapy in adolescents with bipolar I illness.Am J Psychiatry. 1990; 147: 457-461
- Recovery and relapse in adolecents with bipolar affective illness.J Am Acad Child Adolesc Psychiatry. 1994; 34: 724-731
- Genetic studies of affective disorders.J Am Acad Child Adolesc Psychiatry. 1993; 32: 1164-1171
- Mania in childhood.Am J Dis Child. 1976; 130: 380-385
- Bipolar disorder in children.J Am Acad Child Adolesc Psychiatry. 1995; 34: 709-714
- Mania in prepubertal children.J Affect Disord. 1986; 11: 151-154
- Attention deficit hyperactivity disorder in adolescent mania.Am J Psychiatry. 1995; 152: 271-274
- Phenomenology and comorbidity of adolescents hospitalized for the treatment of acute mania.Biol Psychiatry. 1996; 39: 458-460
- The Zurich study. X. Hypomania in a 28- to 30-year-old cohort.Eur Arch Psychiatry Clin Neurosci. 1991; 240: 339-348
- Clinical characteristics of psychiatrically referred adolescent outpatients with substance use disorder.J Am Acad Child Adolesc Psychiatry. 1997; 36: 941-947
- Risk for substance use disorders in youths with child- and adolescent-onset bipolar disorder.J Am Acad Child Adolesc Psychiatry. 1999; 36: 680-685
- Attention deficit hyperactivity disorder (ADHD) is associated with early onset substance use disorders.J Nerv Ment Dis. 1997; 185: 475-482
- Mania-like symptoms suggestive of childhood onset bipolar disorder in clinically referred children.J Am Acad Child Adolesc Psychiatry. 1995; 34: 867-876
- A pilot family study of childhood-onset mania.J Am Acad Child Adolesc Psychiatry. 1995; 34: 1577-1583
- Antecedents and complications of trauma in boys with ADHD.J Am Acad Child Adolesc Psychiatry. 1999; 38: 48-55
- Anxious and non-anxious bipolar disorder.J Affect Disord. 1993; 29: 49-52
Article info
Publication history
Accepted:
April 24,
2000
Received in revised form:
April 24,
2000
Received:
January 12,
2000
Identification
Copyright
© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
