Pediatric Bipolar Disorder: Do we know how to detect it?

ABSTRACT

OBJECTIVE: To review the literature covering the epidemiology, clinical characteristics, longitudinal course, prognosis and clues for the assessment of the Pediatrics Bipolar Disorder (PBD). METHOD: A computerized search in PubMed, looking for published articles since 1980. RESULTS: During the last years, the PBD diagnosis has proliferated largely, with some studies reporting incidences between 1% and 5%. In the past, some researchers reported that atypical symptoms could be more common than the classical symptoms in the PBD. However, current studies confirm the presence of typical mania symptoms in the youngest. Also, they confirm the utility of the diagnostic criteria DSM-IV in this population, with the PBD-NOS as the most prevalent phenotype. Those cases with irritability and without any other maniac symptom are still not clear, but the evidence shows a possible evolution towards others non-bipolar affective disorders. The PBD has high comorbidity, especially with ADHD and Disruptive Behavior Disorders. In the longitudinal evaluation, the PBD cases show high rates of relapse and persistent subsyndromical symptoms. The diagnosis is based in the clinical presentation, with collateral information provided by the family. Screening scales and standardized interview has been developed. CONCLUSIONS: Now days is possible the diagnosis of PBD, although there is not enough information about the categorization and the longitudinal course of the PBD. Future studies are needed in order to clarify these shadows.