Community-based care for youths with early and very-early onset bipolar I disorder.
OBJECTIVE
Phenomenological and treatment differences between children and adolescents with bipolar I disorder in a public mental health system were examined.


METHODS
A systematic medical record review was performed on a sample of 83 patients, focusing on documented DSM IV symptoms of mania or depression, attention deficit hyperactivity disorder, conduct disorder, schizophrenia, and post-traumatic stress disorder. Cross-tabulation and logistic regression analyses were performed comparing the presence/absence of symptoms for each disorder and treatments provided for children and adolescents.


RESULTS
Prepubertal patients were significantly more likely to be male, easily distracted, inattentive, detached from others, hyper-vigilant, prescribed stimulant medication, and to meet the diagnostic criteria for attention-deficit/hyperactivity disorder or Conduct Disorder than adolescents.


CONCLUSIONS
Consistent with the published literature, phenomenological differences between children and adolescents are present and being recognized for differential diagnosis and treatment by community practitioners. More attention to documenting some cardinal symptoms of mania, the persistence of bipolar symptoms, and the nature of cycling for those with mixed states is needed.
Jerrell
Jeanette M
JM
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC 29203, USA. jjerrell@gw.mp.sc.edu
Shugart
Margaret A
MA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D003156:Community Mental Health Services / Q000458:organization & administration*; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology