Bipolar Disorder in Childhood and Adolescence

Abstract

There has been a growing awareness that the onset of bipolar disorder (BD) is often in childhood or adolescence, even though the typical symptom picture of mood dysregulation in adolescence is in many ways dissimilar to the symptom picture in adults. We begin the chapter with a description of the early-onset form of the disorder and a discussion of the controversies surrounding the diagnosis of BD in younger populations. We present epidemiological findings, and discuss what we know about gender and racial/ethnic differences. The phenomenology of adolescent bipolar disorder and the range of functional impairments involved are addressed, with special attention to researchers’ attempts to define the core features of pediatric BD. We cover the research on the course and prognosis of the disorder, co-morbidity, genetics and neurobiology, and neuropsyhological investigations. Finally, we present research on psychosocial treatments, pharmacological treatments, and efforts at prevention. Current models of etiology view bipolar disorder as a primarily genetic illness whose onset and course are influenced by environmental stressors. We examine what is known about the environmental and biological protective and risk factors whose complex interplay over different periods of development result in the expression of the disorder.