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Bipolar Disorder

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Handbook of Adolescent Behavioral Problems

Abstract

Pediatric bipolar disorder (PBD) often presents differently than adult onset bipolar disorder with mixed manic and depressive symptoms, higher incidence of comorbid attention deficit hyperactivity disorder, rapid cycling, and irritability. Biological factors include underactivity of the ventrolateral prefrontal cortex (VLPFC) activity and overactivity of the amygdala during emotion processing. The VLPFC underactivity and striatal overactivity is noted during response inhibition. Concordant findings are also noted with diffusion tensor imaging studies reporting compromised integrity of white matter tracts involving the fronto-striatal and fronto-limbic regions. These functional and structural findings underscore the combined affective and cognitive circuitry disturbances. Neurocognitive difficulties are common in the domains of executive function, attention, working memory, and verbal memory. There is increased fourfold genetic risk in inheriting PBD. Systematic pharmacotherapy algorithm exercises problem-solving strategies in mood stabilization and treatment of comorbidity. Family-focused and individual interventions incorporate cognitive behavioral and interpersonal psychotherapeutic techniques. These complementary multimodal treatment modules that foster resilience and avoid any perceived punitive approaches target the emotion dysregulation and reactivity that underlie the brain circuitry disturbances.

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Authors and Affiliations

  1. Institute for Juvenile Research, University of Illinois at Chicago, 1747 West Roosevelt Road (M/C 747), Chicago, IL, 60608, USA

    Jacklynn Fitzgerald & Mani Pavuluri

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  1. Jacklynn Fitzgerald
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  2. Mani Pavuluri
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Correspondence to Jacklynn Fitzgerald .

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Editors and Affiliations

  1. Child and Family Agency of Southeastern Connecticut, New London, Connecticut, USA

    Thomas P. Gullotta

  2. Value Options, Rocky Hill, Connecticut, USA

    Robert W. Plant

  3. Eastern Connecticut State University, Willimantic, Connecticut, USA

    Melanie A. Evans

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Fitzgerald, J., Pavuluri, M. (2015). Bipolar Disorder. In: Gullotta, T., Plant, R., Evans, M. (eds) Handbook of Adolescent Behavioral Problems. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7497-6_11

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