Early-onset bipolar disorder
and schizophrenia can be very difficult to treat and often requires more than one agent
In adolescents with early-onset bipolar disorder
, 90% have ADHD, compared with 60% of adolescents who have later-occurring bipolar disorder.
Patients with early-onset bipolar disorder were hospitalized for mania much more often than those with NOI.
The median duration of inpatient stay was 22 days for the early-onset bipolar disorder group, compared with 16 days for the NOI group.
Patients with early-onset bipolar disorder also utilized other health care services to a much greater degree than did those with NOI.
Early-onset bipolar disorder is often difficult to recognize and diagnose because distinguishing between normal behaviors and pathological behaviors in children can be challenging, and because symptoms of bipolar disorder may resemble those of, and/or co-occur with, other common childhood-onset mental disorders (Bowring & Kovacs, 1992; National Institute of Mental Health [NIMH], 2000; Papolos & Papolos, 1999).
Early-onset bipolar disorder frequently presents very differently in children than bipolar disorder in adults.
Children with early-onset bipolar disorder rarely fit the classical pattern of bipolar disorder in adults, so using adult criteria to diagnose children may result in a misdiagnosis.
Patients with early-onset bipolar disorder
also used other health care services to a much greater degree than did those with NOI.
The temporal lobes may be enlarged in early-onset bipolar disorder
but decreased in early-onset schizophrenia and maybe in autism spectrum disorders.
Recent studies have shown that manic symptoms in children are more common than once thought, and early-onset bipolar disorders
have generated huge interest in the scientific community and the public.
New chapters on child psychiatry have been added, including depressive disorders and suicide, early-onset bipolar disorders
, neuroimaging, and the impact of terrorism on children.