Mania-Like Symptoms Suggestive of Childhood-Onset Bipolar Disorder in Clinically Referred Children

doi:10.1097/00004583-199507000-00010

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 34, Issue 7, July 1995, Pages 867-876

https://doi.org/10.1097/00004583-199507000-00010 Get rights and content

ABSTRACT

Objective

To examine the prevalence, characteristics, and correlates of mania among referred children aged 12 or younger. Many case reports challenge the widely accepted belief that childhood-onset mania is rare. Sources of diagnostic confusion include the variable developmental expression of mania and its symptomatic overlap with attention-deficit hyperactivity disorder (ADHD).

Method

The authors compared 43 children aged 12 years or younger who satisfied criteria for mania, 164 ADHD children without mania, and 84 non-ADHD control children.

Results

The clinical picture was fully compatible with the DSM-III-R diagnosis of mania in 16% (n = 43) of referred children. All but one of the children meeting criteria for mania also met criteria for ADHD. Compared with ADHD children without mania, manic children had significantly higher rates of major depression, psychosis, multiple anxiety disorders, conduct disorder, and oppositional defiant disorder as well as evidence of significantly more impaired psychosocial functioning. In addition, 21% (n = 9) of manic children had had at least one previous psychiatric hospitalization.

Conclusions

Mania may be relatively common among psychiatrically referred children. The clinical picture of childhood-onset mania is very severe and frequently comorbid with ADHD and other psychiatric disorders. Because of the high comorbidity with ADHD, more work is needed to clarify whether these children have ADHD, bipolar disorder, or both. J. Am. Acad. Child Adolesc. Psychiatry, 1995, 34, 7:867–876.

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: This work was supported in part by the National Alliance for Research on Schizophrenia and Depression, by the Eli Lilly Pilot Research Award through the American Academy of Child and Adolescent Psychiatry (Dr. Wozniak), and by grants RO1 MH41314-07 and RO1 MH50657-02 from the National Institute of Mental Health (Dr. Biederman).

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ARTICLESMania-Like Symptoms Suggestive of Childhood-Onset Bipolar Disorder in Clinically Referred Children

ABSTRACT

Objective

Method

Results

Conclusions

J Am Acad Child Adolesc Psychiatry

J Affect Disord

Compr Psychiatry

J Am Acad Child Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Affect Disord

J Am Acad Child Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Affect Disord

Affective disorders in referred children and younger siblings of manic-depressives: mode of onset and prospective course

Arch Gen Psychiatry

Manic-depressive psychosis in childhood

J Child Psychol Psychiatry

The “atypical” picture of adolescent mania

Am J Psychiatry

Bipolar affective disorder in adolescence: a 10-year study

Aust N Z J Psychiatry

Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder (ADHD): patterns of comorbidity in probands and relatives in psychiatrically and pediatrically referred samples

Arch Gen Psychiatry

Psychiatric correlates of behavioral inhibition in young children of parents with and without psychiatric disorders

Arch Gen Psychiatry

Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients

Arch Gen Psychiatry

Manic depressive psychosis in children: report of 18 cases

J Nerv Ment Dis

Bipolar affective disorders in childhood and adolescence

Classification issues of bipolar disorders in childhood

Psychiatr Dev

The assessment of affective disorders in children and adolescents by semistructured interview

Arch Gen Psychiatry

Manic depressive illness in adolescence and childhood: review and case report

Can J Psychiatry

Manic-depressive variant syndrome of childhood: a preliminary report

Am J Psychiatry

ARTICLES
Mania-Like Symptoms Suggestive of Childhood-Onset Bipolar Disorder in Clinically Referred Children