Advances in the neurobiology of pediatric bipolar disorderHow Cardinal are Cardinal Symptoms in Pediatric Bipolar Disorder? An Examination of Clinical Correlates
Section snippets
Methods and Materials
Subjects were youth (≤18 years) with DSM-IV BPD on structured diagnostic interview and confirmed by clinical interview, who had been consecutively referred to a family study of pediatric bipolar disorder from ascertained outpatients from our Pediatric Psychopharmacology Clinic at Massachusetts General Hospital (MGH). Thus, parents calling for a psychiatric evaluation of their child were told about the family genetic study of pediatric bipolar disorder. Those interested who also met inclusion
Results
Subjects were 86 subjects with structured diagnostic interview diagnosis of DSM-IV bipolar disorder ascertained from a family genetic study of pediatric bipolar disorder endorsing either euphoria or irritability or both. Euphoria was reported by 44 (51%) of these subjects and irritability by 81 (94%) of subjects. Of the subjects with irritability, 48% (n = 39) also reported euphoria. Because the number of subjects without irritability was small (n = 5; 6%), we compared children with
Discussion
The main goal of this study was to test whether the hypothesized cardinal symptom of euphoria resulted in differences in clinical correlates in bipolar youth ascertained with no a priori assumptions about cardinal symptoms. Among Criterion A (abnormal mood), we found that severe irritability was the predominant abnormal mood rather than euphoria (94% vs. 51%). We also found that among Criterion B items, grandiosity was not uniquely overrepresented in youth with mania, nor did the rate of
References (32)
- et al.
Proposed multidimensional structure of maniabeyond the euphoric-dysphoric dichotomy
J Affect Disord
(2003) - et al.
Further evidence of unique developmental phenotypic correlates of pediatric bipolar disorderFindings from a large sample of clinically referred preadolescent children assessed over the last 7 years
J Affect Disord
(2004) - et al.
Attention deficit hyperactivity disorder and juvenile maniaAn overlooked comorbidity?
J Am Acad Child Adolesc Psychiatry
(1996) - et al.
Manic symptoms in psychiatrically hospitalized children- what do they mean?
J Affect Disord
(1998) - et al.
How reliable are maternal reports of their children’s psychopathology?One year recall of psychiatric diagnoses of ADHD children
J Am Acad Child Adolesc Psychiatry
(1995) - et al.
Is there progression from irritability/dyscontrol to major depressive and manic symptoms?A retrospective community survey of parents of bipolar children
J Affect Disord
(2003) - et al.
Heterogeneity of Irritability in ADHD Subjects with and without Mood Disorders
Biol Psychiatry
(2005) - et al.
Long-term implications of early onset in bipolar disorderData from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)
Biol Psychiatry
(2004) - et al.
Recovery and relapse in adolescents with bipolar affective illnessA five-year naturalistic, prospective follow-up
J Am Acad Child Adolesc Psychiatry
(1995) - et al.
Mania-like symptoms suggestive of childhood onset bipolar disorder in clinically referred children
J Am Acad Child Adolesc Psychiatry
(1995)
Convergence between structured diagnostic interviews and clinical assessment on the diagnosis of pediatric-onset bipolar disorder
Biol Psychiatry
The diagnosis and treatment of adolescent anxiety disorders
J Clin Psychiatry
The pattern of hostility in affective illness
Br J Psychiatry
Classification issues of bipolar disorders in childhood
Psychiatr Dev
The mood spectrum in unipolar and bipolar disorder arguments
Am J Psychiatry
Manic-depressive variant syndrome of childhoodA preliminary report
Am J Psychiatry
Cited by (92)
A brief online intervention to address aggression in the context of emotion-related impulsivity for those treated for bipolar disorder: Feasibility, acceptability and pilot outcome data
2020, Journal of Behavioral and Cognitive TherapyPhenomenology and diagnostic stability of paediatric bipolar disorder in a Spanish sample
2019, Journal of Affective DisordersCitation Excerpt :Some authors propose the existence of different phenotypes depending on the severity of BD symptoms (Leibenluft et al., 2003). However, consistent with the suggestions of other experts (Wozniak et al., 2005), our study indicates that the diagnostic criteria proposed by the DSM are suitable for the identification and diagnosis of BD in children and adolescents. In our sample of 72 patients with DSM-IV BD who were followed for up to 15 years, with a median follow up of 3.86 years, only three patients (4.2%) did not meet the criteria for a diagnosis of BD at the end of the follow-up period.
Neurocognitive functioning in euthymic patients with bipolar disorder and unaffected relatives: A review of the literature
2016, Neuroscience and Biobehavioral ReviewsAnger in psychological disorders: Prevalence, presentation, etiology and prognostic implications
2016, Clinical Psychology ReviewCitation Excerpt :Although much of the emotion research in bipolar disorder (BD) has focused on happiness, excessive anger is a cardinal symptom of mania within the DSM-5 diagnostic criteria (American Psychiatric Association, 2013). In support of the diagnostic emphasis on anger, anger is identified as a core facet of manic symptoms across several factor analytic studies of adults (Cassidy, Forest, Murry, & Carroll, 1998; Serretti & Olgiati, 2004), and is observed in most manic episodes among children and adolescents (Hunt et al., 2009; Wozniak et al., 2005). In adults and children with BD, anger is highly common.
Emotion-relevant impulsivity predicts sustained anger and aggression after remission in bipolar I disorder
2016, Journal of Affective Disorders