title: Juvenile bipolar disorder in Brazil: clinical and treatment findings.
abstract: BACKGROUND
  Because few studies were conducted to evaluate bipolar disorder in children and adolescents outside North America, this investigation aims to describe clinical features, pattern of comorbidities, and response to pharmacologic treatment in a sample of youths with bipolar disorder (BD) from a pediatric psychopharmacology outpatient clinic in Brazil.
  
  
  METHODS
  We performed a retrospective chart review of all patients under age 15 with BD diagnoses who were evaluated and treated in our clinic from 1998-2001. A comparison sample of subjects with attention-deficit/hyperactivity disorder (ADHD) without BD (n = 362) was also evaluated.
  
  
  RESULTS
  The prevalence of juvenile BD in our sample was 7.2% (36/500) (95% confidence interval = 5.2-9.9). Irritable mood was detected in 91.7% of the bipolar patients. The main comorbidity found was ADHD (58.3%). Children with BD had significantly higher rates of abnormally elevated CBCL scores in the externalizing dimension, anxiety and depression, delinquent behavior, and aggressive behavior scales than ADHD subjects (p <.05). Most BD patients (78%) needed combination drug therapy to achieve symptomatic control.
  
  
  CONCLUSIONS
  Our results replicate clinical and treatment findings from U.S. investigations in a different culture demonstrating that juvenile BD is not a rare disorder in clinical samples.
authors.affiliation: Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
authors.forename: Silzá
authors.initials: S
authors.lastname: Tramontina
authors.forename: Marcelo
authors.initials: M
authors.lastname: Schmitz
authors.forename: Guilherme
authors.initials: G
authors.lastname: Polanczyk
authors.forename: Luis A
authors.initials: LA
authors.lastname: Rohde
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001008:Anxiety Disorders / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012189:Retrospective Studies; D017678:Sex Distribution