title: Preschool Bipolar Disorder: Brazilian children case reports.
abstract: OBJECTIVE
  This study describes the clinical phenomenology and family history of preschool age onset Bipolar Disorder (BD).
  
  
  METHODS
  Eight children and adolescents out of 118 cases (6.78%), both genders, meeting current DSM-IV criteria diagnosis of BD were described. The clinical assessment, CBCL, DICA-IV and CGAS were performed directly with each patient and their parents.
  
  
  RESULTS
  Most (87.5%) presented classical symptoms of mania: euphoria, grandiosity, irritability, psychomotor agitation and agitated sleep or, in the same proportion, sleeplessness. Hyperactivity and increase of energy were found in all eight cases. The clinical course varied from a rapid, ultra-rapid, ultradian cycle to a continued pattern. Five out of eight children (62.5%) presented aggressiveness toward others and one deliberate self-harm. Most (87.5%) had psychiatric family history. The average number of medications used during their life was 4.5 drugs.
  
  
  CONCLUSIONS
  The small sample and retrospective reports of the first manic symptoms in three of the cases (cases V, VI and VII).
  
  
  CONCLUSIONS
  An important incidence of classical manic features was found in very young children. The clinical course tended to be continuous, and preschool BD seems to have a strong association with affective disorder family history.
authors.affiliation: University of Sao Paulo School of Medicine The Child and Adolescent Psychiatry Service, Institute of Psychiatry Alameda Ministro Rocha Azevedo, 4 Sao Paulo, SP 01410-000, Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Ferreira Maia
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Boarati
authors.forename: Ana
authors.initials: A
authors.lastname: Kleinman
authors.forename: Lee
authors.initials: L
authors.lastname: Fu-I
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001938:Brazil; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D018692:Antimanic Agents; D000697:Central Nervous System Stimulants