title: Juvenile bipolar disorder.
abstract: OBJECTIVE
  Bipolar disorder in children and adolescents is less well studied than bipolar disorder in adults. This review addresses issues related to its underdiagnosis, precursors of bipolarity, comorbidity, natural course and treatment.
  
  
  METHODS
  Literature from Medline and other searches, and earlier relevant articles including references from recent review articles on juvenile bipolarity were reviewed.
  
  
  RESULTS
  Bipolar disorder in juveniles is underdiagnosed and misdiagnosed on various counts. Few recent studies have reported high rates of comorbid attention deficit and disruptive disorders, prompting some researchers to consider them as probable developmental precursors of juvenile bipolarity. There is also evidence to suggest that some juvenile depression could be pre-bipolar, and that certain temperamental predispositions are probable precursors to bipolarity. Limited data on the natural course and outcome suggest that juvenile bipolar disorder is a highly recurring illness as in adults, and that it is associated with significant functional impairment. The psychopharmacological treatment of juvenile bipolar disorder is remarkably understudied, and treatment is often based on studies of adults.
  
  
  CONCLUSIONS
  There is a need for epidemiological studies of juvenile bipolar disorder. Similarly, there is an urgent need for the methodologically rigorous studies to establish the efficacy of various antimanic drugs. Finally, issues related to comorbidity and temperamental predispositions to juvenile bipolarity need greater clarity, as they may have important treatment and research implications.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Y C
authors.initials: YC
authors.lastname: Reddy
authors.forename: S
authors.initials: S
authors.lastname: Srinath
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D000297:Psychology, Adolescent
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D008094:Lithium