title: Pediatric bipolar disorder: recognition in primary care.
abstract: OBJECTIVE
  Bipolar disorder (BPD) is increasingly diagnosed in youth in both outpatient and inpatient settings. Research on BPD in youth has also increased dramatically; this paper summarizes issues of clinical relevance in primary care, advancements in the last year, and areas in which more research is needed.
  
  
  RESULTS
  Key issues and new developments are summarized in the following areas such as epidemiology and relevance, assessment and differential diagnosis, patient and family decision support, shared decision making and triage, treatment, and monitoring and collaboration with mental health professionals. Recent practice guidelines have important implications for diagnosis and treatment.
  
  
  CONCLUSIONS
  Early-onset BPD appears to have a more severe course and more comorbidity than later life onset, as well as longer delays in treatment seeking. Affected children show differences in cognitive functioning and neuroanatomy compared with the general population. Assessment of BPD in children needs to be comprehensive and longitudinal, as diagnosis remains a debated topic. Medications are a primary part of treatment, but more double-blind, placebo-controlled trials are needed. Psychosocial adjunctive treatment is important. Children with a family history of BPD are at risk for impaired functioning and psychopathology; high-risk studies will increase our understanding of the onset and course of BPD.
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, Ohio 43210-1250, USA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Cummings
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fristad
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010372:Pediatrics / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
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