Pediatric bipolar disease: current and future perspectives for study of its long-term course and treatment.
OBJECTIVE
Findings from recent long-term, prospective longitudinal studies of the course, outcome and naturalistic treatment of adults with bipolar illness are highlighted as background for long-term developmental study of pediatric bipolar illness.


RESULTS
Accumulating knowledge of bipolar illness in adults underscores a high risk for multiple recurrences through the lifespan, significant medical morbidity, high rates of self-harm, economic and social burden and frequent treatment resistance with residual symptoms between major episodes. At present, there is no empirical foundation to support any assumption about the long-term course or outcome of bipolar illness when it arises in childhood or adolescence, or the effects of conventional pharmacotherapies in altering its course and limiting potentially adverse outcomes. The proposed research articulates specific descriptive aims that draw on adult findings and outlines core methodological requirements for such an endeavor.


CONCLUSIONS
Innovations in the description and quantitative analysis of prospective longitudinal clinical data must now be extended to large, systematically ascertained pediatric cohorts recruited through multicenter studies if there is to be a meaningful scientific advance in our knowledge of the enduring effects of bipolar illness and the potential value of contemporary approaches to its management.
Strober
Michael
M
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024-1759, USA. mstrober@mednet.ucla.edu
Birmaher
Boris
B
Ryan
Neal
N
Axelson
David
D
Valeri
Sylvia
S
Leonard
Henrietta
H
Iyengar
Satish
S
Gill
Mary Kay
MK
Hunt
Jeffrey
J
Keller
Martin
M
D017668:Age of Onset; D001714:Bipolar Disorder / Q000453:epidemiology / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D010372:Pediatrics; D016896:Treatment Outcome