Pharmacotherapy in the community-based treatment of children with bipolar I disorder.
OBJECTIVE
To examine the services and medications received, and psychosocial functioning changes over time of children and adolescents with bipolar I disorder in a public mental health system.


METHODS
Medical records were reviewed for 82 patients, 6-17 years of age, diagnosed with bipolar I disorder, and newly admitted to one public mental health system between 1 July 2003 and 30 June 2004. A retrospective cohort design was employed, with an 18-month follow-up period.


RESULTS
One-third of the patients dropped out treatment within a few months. The psychosocial functioning ratings of patients who remained in treatment improved over time on several dimensions (total, school/work, behavior toward others). Children and adolescents prescribed both a mood stabilizer and an atypical antipsychotic medication regimen (35%) were rated as higher functioning on self-harm behavior and mood/emotions by clinical staff, but their improvement could not be attributed directly to the pharmacotherapy in this small cohort.


CONCLUSIONS
Community-based pharmacotherapy for children and adolescents with bipolar I disorder does not differ substantially from the extant literature, given the complexity and severity of these cases, and may lead to improvement for children and adolescents who remain in treatment.
Jerrell
Jeanette M
JM
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA. jjerrell@gw.mp.sc.edu
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D010372:Pediatrics; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies
D014150:Antipsychotic Agents