title: Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality.
abstract: OBJECTIVE
  Children are developmentally incapable of many manifestations of bipolar symptoms described in adults (e.g., children do not "max" out credit cards or have four marriages). To address this issue, our group investigated prepubertal and early adolescent age equivalents of adult mania behaviors.
  
  
  METHODS
  Details of the methods appear in the companion article in this issue (Geller et al. 2002a). Subjects had a prepubertal and early adolescent bipolar disorder phenotype (PEA-BP) that was validated by reliable assessment (Geller et al. 2001b), 6-month stability (Geller et al. 2000c), and 1- and 2-year longitudinal diagnostic outcome (Geller et al. 2001a, 2002b).
  
  
  RESULTS
  Examples of elation, grandiosity, decreased need for sleep, racing thoughts, and hypersexuality in PEA-BP subjects were compared to examples in prepubertal normal controls and to examples in late teenage/adult-onset mania. Because it is not intuitive that children can be pathologically happy or expansive, sections on guidelines for differentiating normal versus impairing elation and grandiosity are provided.
  
  
  CONCLUSIONS
  Due to the high comorbidity of PEA-BP and attention deficit hyperactivity disorder (ADHD), recognition of mania symptoms that do not overlap with those for ADHD may aid in avoiding both under- and overdiagnosis of child bipolar disorder. A discussion of how "nonoverlapping with ADHD" Diagnostic and Statistical Manual of Mental Disorders (4th ed.) mania symptoms can be useful in the differential diagnosis of irritability is also provided.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA. gellerb@medicine.wustl.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Geller
authors.forename: Betsy
authors.initials: B
authors.lastname: Zimerman
authors.forename: Marlene
authors.initials: M
authors.lastname: Williams
authors.forename: Melissa P
authors.initials: MP
authors.lastname: Delbello
authors.forename: Jeanne
authors.initials: J
authors.lastname: Frazier
authors.forename: Linda
authors.initials: L
authors.lastname: Beringer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001686:Biological Phenomena; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D006970:Disorders of Excessive Somnolence / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D019964:Mood Disorders / Q000209:etiology* / Q000523:psychology; D019529:Sexuality / Q000523:psychology*