title: Is increased sexual behavior a symptom of bipolar disorder in children and adolescents?
abstract: While there is consensus that bipolar disorder exists in children and adolescents, its diagnostic criteria are debated. Excessive sexual behavior has been reported in youth who may have juvenile bipolar disorder (JBD), and has been termed "hypersexuality." Although there is no universal definition of this term, this observation has led to a hypothesis that increased sexual behavior characterizes the bipolar syndrome in children and adolescents, and differentiates it from attention deficit hyperactivity disorder. Although this hypothesis is plausible, evidence for it is incomplete, because testing it definitively would require both establishing a standard definition of hypersexuality in children and adolescents, and also reaching consensus about the other nonsexual criteria for pediatric bipolar disorder. In addition, studies to test it would need to control factors other than JBD that are known to increase sexual behavior in children and adolescents. These include sexual abuse and related posttraumatic stress disorder, excessive exposure to sexual stimuli, psychiatric illness in general, and social variables such as family chaos and social stress. Some of these factors might increase sexual behavior in youth with bipolar disorder through psychodynamic mechanisms rather than as a result of the illness itself. Therefore, further research is needed to determine whether increased sexual behavior can serve as a diagnostically valuable criterion for bipolar disorder in children and adolescents, and whether it differentiates the disorder from other conditions known to be associated with increased sexual behavior in youth.
authors.affiliation: Divisions of Child and Adolescent Psychiatry and of Gender, Sexuality and Health, Columbia University College of Physicians and Surgeons, USA. sla15@columbia.edu
authors.forename: Stewart
authors.initials: S
authors.lastname: Adelson
authors.forename: Robinette
authors.initials: R
authors.lastname: Bell
authors.forename: Adam
authors.initials: A
authors.lastname: Graff
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Haase
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Downey
authors.forename: Richard C
authors.initials: RC
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology* / Q000523:psychology; D001714:Bipolar Disorder / Q000503:physiopathology*; D002648:Child; D006801:Humans; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology