Clinical Child and Family Psychology Review

, Volume 12, Issue 3, pp 271–293

Early-Onset Bipolar Spectrum Disorders: Diagnostic Issues

  • Stephanie Danner
  • Mary A. Fristad
  • L. Eugene Arnold
  • Eric A. Youngstrom
  • Boris Birmaher
  • Sarah M. Horwitz
  • Christine Demeter
  • Robert L. Findling
  • Robert A. Kowatch
  • The LAMS Group
Article

DOI: 10.1007/s10567-009-0055-2

Cite this article as:
Danner, S., Fristad, M.A., Arnold, L.E. et al. Clin Child Fam Psychol Rev (2009) 12: 271. doi:10.1007/s10567-009-0055-2

Abstract

Since the mid 1990s, early-onset bipolar spectrum disorders (BPSDs) have received increased attention in both the popular press and scholarly press. Rates of diagnosis of BPSD in children and adolescents have increased in inpatient, outpatient, and primary care settings. BPSDs remain difficult to diagnose, particularly in youth. The current diagnostic system makes few modifications to accommodate children and adolescents. Researchers in this area have developed specific BPSD definitions that affect the generalizability of their findings to all youth with BPSD. Despite knowledge gains from the research, BPSDs are still difficult to diagnose because clinicians must: (1) consider the impact of the child’s developmental level on symptom presentation (e.g., normative behavior prevalence, environmental limitations on youth behavior, pubertal status, irritability, symptom duration); (2) weigh associated impairment and course of illness (e.g., neurocognitive functioning, failing to meet full DSM criteria, future impairment); and (3) make decisions about appropriate assessment (differentiating BPSD from medical illnesses, medications, drug use, or other psychiatric diagnoses that might better account for symptoms; comorbid disorders; informant characteristics and assessment measures to use). Research findings concerning these challenges and relevant recommendations are offered. Areas for further research to guide clinicians’ assessment of children with early-onset BPSD are highlighted.

Keywords

Bipolar disorder Children Adolescents Diagnosis Phenomenology 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Stephanie Danner
    • 1
  • Mary A. Fristad
    • 1
  • L. Eugene Arnold
    • 1
  • Eric A. Youngstrom
    • 2
  • Boris Birmaher
    • 3
  • Sarah M. Horwitz
    • 4
  • Christine Demeter
    • 5
  • Robert L. Findling
    • 5
  • Robert A. Kowatch
    • 6
  • The LAMS Group
  1. 1.Ohio State UniversityColumbusUSA
  2. 2.University of North CarolinaChapel HillUSA
  3. 3.University of PittsburghPittsburghUSA
  4. 4.Stanford UniversityStanfordUSA
  5. 5.Case Western Reserve UniversityClevelandUSA
  6. 6.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA

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