Pediatric bipolar disorder: recognition in primary care.
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.
Cummings
Colleen M
CM
Department of Psychology, The Ohio State University, Columbus, Ohio 43210-1250, USA.
Fristad
Mary A
MA
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
D000928:Antidepressive Agents
J Am Acad Child Adolesc Psychiatry. 2007 Jan;46(1):107-125
17195735
J Clin Psychiatry. 2007 May;68(5):781-8
17503990
Eur Neuropsychopharmacol. 2007 May-Jun;17(6-7):440-7
17258897
J Affect Disord. 2007 Apr;99(1-3):27-36
17049378
Exp Clin Psychopharmacol. 2007 Dec;15(6):555-62
18179308
Aust N Z J Psychiatry. 2007 Jun;41(6):479-84
17508317
J Child Adolesc Psychiatr Nurs. 2007 Feb;20(1):40-58
17284237
J Affect Disord. 2007 Mar;98(3):263-6
16949161
Bipolar Disord. 2007 Aug;9(5):496-503
17680920
J Am Acad Child Adolesc Psychiatry. 2007 Oct;46(10):1299-1306
17885571
Bipolar Disord. 2007 Dec;9(8):828-38
18076532
Am J Psychiatry. 2007 Aug;164(8):1238-41
17671287
Bipolar Disord. 2007 Dec;9(8):895-900
18076540
Eur Child Adolesc Psychiatry. 2007 Jun;16(4):222-8
17136299
J Am Acad Child Adolesc Psychiatry. 2007 Feb;46(2):205-12
17242624
J Clin Psychiatry. 2007 May;68(5):789-95
17503991
Arch Gen Psychiatry. 2007 Sep;64(9):1032-9
17768268
J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):1070-1079
17667485
Can J Psychiatry. 2007 Jul;52(7):418-25
17688005
Child Psychiatry Hum Dev. 2007 Jun;38(1):47-55
17160586
Biol Psychiatry. 2007 Jul 15;62(2):107-14
17306773
Bipolar Disord. 2007 Nov;9(7):698-705
17988359
J Affect Disord. 2007 Mar;98(3):207-13
16920198
Psychopharmacology (Berl). 2007 Mar;191(1):39-54
17093980
Biol Psychiatry. 2007 Jul 15;62(2):115-20
16950211
J Clin Psychiatry. 2007 Oct;68(10):1565-73
17960974
Bipolar Disord. 2007 May;9(3):243-51
17430299
Bipolar Disord. 2007 Jun;9(4):339-44
17547580
Bipolar Disord. 2007 Dec;9(8):888-94
18076539
J Am Acad Child Adolesc Psychiatry. 2007 Feb;46(2):197-204
17242623
Neurosci Lett. 2007 Feb 21;413(3):183-6
17276600
J Child Adolesc Psychopharmacol. 2007 Feb;17(1):97-103
17343557
Eur Arch Psychiatry Clin Neurosci. 2007 Jun;257(4):217-21
17287927
Eur Psychiatry. 2007 Mar;22(2):92-8
17142013
Eur Child Adolesc Psychiatry. 2007 Dec;16(8):510-6
17846818
J Affect Disord. 2007 Sep;102(1-3):131-6
17275096
Biol Psychiatry. 2007 Mar 15;61(6):758-64
17166485
Eur Child Adolesc Psychiatry. 2007 Apr;16(3):187-98
17136501
Am J Psychiatry. 2007 Apr;164(4):582-90
17403971
Can J Psychiatry. 2007 Jul;52(7):409-17
17688004
CNS Spectr. 2007 Sep;12(9):683-9
17805214
J Am Acad Child Adolesc Psychiatry. 2007 Mar;46(3):341-355
17314720
Biol Psychiatry. 2007 Mar 15;61(6):819-21
17338904
J Pediatr. 2007 May;150(5):485-90
17452221