Clinical phenomenology in children and adolescents with bipolar disorder

Abstract

Objective: The aim of our study was to evaluate the clinical phenomenology, prognosis, comorbidity, and the effect of resilience on clinical course in hospitalized children and adolescents with bipolar disorder (BD) by comparing them with and without psychotic features. Method: The study group included 60 cases with BD in the inpatient unit of the Child and Adolescent Psychiatry Clinic of Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery. Psychiatric assessment and comorbid disorders were established using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. We also administered the Young Mania Rating Scale (YMRS) for manic symptoms, Positive and Negative Syndrome Scale (PANSS) for psychotic symptoms, Child and Youth Resilience Measure, and Children Global Assessment Scale to the patients. The patients were evaluated during the remission period. Results: Psychotic symptoms were found in 76.7% of the cases in our study. They were significantly higher in male cases. The most common symptom found was a decreased need for sleep. The scores of YMRS and PANSS were significantly higher in psychotic cases. The comorbidity of Attention Deficit Hyperactivity Disorder was found to be significantly higher in nonpsychotic cases. No difference was found in both groups in terms of resilience. Conclusion: Poor judgment and persecutory delusions were predictors of poor clinical course in children and adolescents with BD. Evaluating relevant predictors in larger study samples will provide more significant results in predicting clinical course in patients with BD.