Treatment-Emergent Mania in a Prepubertal Boy.

Bipolar disorder among children has gained acceptance as a diagnostic entity but continues to pose diagnostic and management challenges due to the developmental differences in children and inadequate evidence for pharmacological management. We present the case of a prepubertal child presenting with an apparent depressive episode who developed treatment-emergent mania when commenced on sertraline. This case highlights the need for further research into the presentations and pharmacological management of prepubertal children with bipolar affective disorder.

Characteristics of mothers' depressive illness as predictors for emotional and behavioural problems in children in a Sri Lankan setting.

INTRODUCTION: Maternal depression has been shown to be associated with neurodevelopmental, emotional and behavioural disorders in offspring. We aimed to describe the proportion of psychological problems among children of mothers with depression in Sri Lanka and to describe the association with the characteristics of the mothers' illness. METHODS: A cross-sectional descriptive study was conducted on 100 children and adolescents between 4-16 years whose mother has a diagnosis of depression and currently in remission. Specifically designed instruments were used to extract socio-demographic details and data on mother's illness. Strengths and Difficulties Questionnaire (SDQ) was used to detect psychological problems in children. RESULTS: 14 % of the children scored abnormally high in hyperactivity, 13 % in conduct problems, 12 % in emotional problems, 9 % in peer problems. Hyperactivity, internalizing problems, and total difficulties were significantly higher in where mothers' had a history of a moderate depressive episode and recurrent depressive disorder. Children whose mothers had no attempts of self-harm scored significantly higher in both emotional problems and internalizing problems. Children whose mothers have comorbid illness scored significantly higher in hyperactivity, conduct problems, emotional problems, externalizing problems, internalizing problems and total difficulties. CONCLUSIONS: Screening for psychological problems in children and developing a holistic management plan which include steps to ensure the well-being of the children is important in managing mothers with depression.