A comparison of the phenomenology and treatment of youths and adults with bipolar I disorder in a state mental health system.
BACKGROUND
Presenting symptoms of and treatments used for child/adolescent and adult patients diagnosed with bipolar I disorder in a state mental health system are described and compared.


METHODS
Medical records were reviewed for 267 cases of bipolar I disorder reported in the statewide patient information system.


RESULTS
The child/adolescent patients were significantly more likely to have irritability documented, be treated with stimulant medications, and meet the criteria for major depression while adults were significantly more likely to have a broader array of documented symptoms: euphoria, fatigue, trouble concentrating, and hyper-religiosity. Suicidality (thoughts and gestures) was higher in both age groups than previously reported in the clinical literature. No difference was evident in the mood-related pharmacotherapy. Child/adolescent cases were seen more often for re-evaluations, medication visits, and individual and family therapy sessions, whereas adult cases were more likely to receive case management services and less-frequent medication monitoring visits.


CONCLUSIONS
Youths with bipolar I disorder were more likely to present with irritability and depressive symptoms, and be treated with stimulants and a range of therapeutic interventions, whereas adults with more broadly documented symptoms were receiving minimal treatment services.
Jerrell
Jeanette M
JM
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC 29203, USA. jjerrell@medpark.sc.edu
Shugart
Margaret A
MA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003156:Community Mental Health Services / Q000458:organization & administration*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005196:Family Therapy; D006292:Health Priorities; D006801:Humans; D007508:Irritable Mood; D016015:Logistic Models; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011613:Psychotherapy
D000697:Central Nervous System Stimulants