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Bipolar depression in children and adolescents

Published online by Cambridge University Press:  10 April 2013

Melissa S. DeFilippis*
Affiliation:
Department of Child and Adolescent Psychiatry, The University of Texas Medical Branch, Galveston, Texas, USA
Karen Dineen Wagner
Affiliation:
Department of Child and Adolescent Psychiatry, The University of Texas Medical Branch, Galveston, Texas, USA Department of Psychiatry, The University of Texas Medical Branch, Galveston, Texas, USA
*
*Address for correspondence: Melissa S. DeFilippis, MD, 301 University Blvd., Galveston, TX 77555-0188, USA. (Email msdefili@utmb.edu)

Abstract

Children and adolescents with bipolar disorder may have depression as the presenting mood state. It is important for clinicians to distinguish between unipolar and bipolar depression in youth. Depressive episodes are common during the course of bipolar illness in children and adolescents. Evidence-based treatments are needed to guide clinicians’ treatment decisions for youth with bipolar depression. This article reviews the prevalence, diagnosis, course, and treatment of bipolar depression in youth, and emphasizes the need for large, controlled treatment studies in the pediatric population.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

1.Lewinsohn, PM, Klein, DN, Seeley, JR. Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. J Am Acad Child Adolesc Psychiatry. 1995; 34(4): 454463.CrossRefGoogle Scholar
2.Merikangas, KR, He, JP, Burstein, M, etal. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010; 49(10): 980989.CrossRefGoogle ScholarPubMed
3.Merikangas, KR, Cui, L, Kattan, G, etal. Mania with and without depression in a community sample of US adolescents. Arch Gen Psychiatry. 2012; 69(9): 943951.CrossRefGoogle Scholar
4.Merikangas, K, Lamers, F. The “true” prevalence of bipolar II disorder. Curr Opin Psychiatry. 2011; 25(1): 1923.CrossRefGoogle Scholar
5.Faedda, GL, Baldessarini, RJ, Glovinsky, IP, etal. Pediatric bipolar disorder: phenomenology and course of illness. Bipolar Disord. 2004; 6(4): 305313.CrossRefGoogle ScholarPubMed
6.Dilsaver, SC, Benazzi, F, Akiskal, HS. Mixed states: the most common outpatient presentation of bipolar depressed adolescents? Psychopathology. 2005; 38(5): 268272.CrossRefGoogle ScholarPubMed
7.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
8.Wozniak, J, Spencer, T, Biederman, J, etal. The clinical characteristics of unipolar vs. bipolar major depression in ADHD youth. J Affect Disord. 2004; 82(Suppl 1): S59S69.CrossRefGoogle ScholarPubMed
9.Wagner, KD, Findling, RL, Emslie, GJ, etal. Validation of the Mood Disorder Questionnaire for Bipolar Disorders in Adolescents. J Clin Psychiatry. 2006; 67: 827830.CrossRefGoogle ScholarPubMed
10.Youngstrom, EA, Frazier, TW, Findling, RL, etal. Developing a ten item short form of the Parent General Behavior Inventory to assess for juvenile mania and hypomania. J Clin Psychiatry. 2008; 69: 831839.CrossRefGoogle Scholar
11.Pavuluri, MN, Henry, DB, Devineni, B, etal. Child mania rating scale: development, reliability, and validity. J Am Acad Child Adolesc Psychiatry. 2006; 45: 550560.CrossRefGoogle ScholarPubMed
12.Wozniak, J, Petty, CR, Schreck, M, etal. High level of persistence of pediatric bipolar-I disorder from childhood onto adolescent years: a four year prospective longitudinal follow-up study. J Psychiatr Res. 2011; 45(10): 12731282.CrossRefGoogle Scholar
13.Jairam, R, Srinath, S, Girimaji, SC, etal. A prospective 4–5 year follow-up of juvenile onset bipolar disorder. Bipolar Disord. 2004; 6(5): 386394.CrossRefGoogle ScholarPubMed
14.Birmaher, B, Axelson, D, Goldstein, B, etal. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the Course and Outcome of Bipolar Youth (COBY) study. Am J Psychiatry. 2009; 166(7): 795804.CrossRefGoogle ScholarPubMed
15.Geller, B, Tillman, R, Craney, JL, etal. Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. Arch Gen Psychiatry. 2004; 61(5): 459467.CrossRefGoogle ScholarPubMed
16.Geller, B, Tillman, R, Bolhofner, K, etal. Child bipolar I disorder: prospective continuity with adult bipolar I disorder; characteristics of second and third episodes; predictors of 8-year outcome. Arch Gen Psychiatry. 2008; 65(10): 11251133.CrossRefGoogle ScholarPubMed
17.DelBello, MP, Chang, K, Welge, JA, etal. A double-blind, placebo-controlled pilot study of quetiapine for depressed adolescents with bipolar disorder. Bipolar Disord. 2009; 11(5): 483493.CrossRefGoogle ScholarPubMed
18.Chang, K, Saxena, K, Howe, M. An open-label study of lamotrigine adjunct or monotherapy for the treatment of adolescents with bipolar depression. J Am Acad Child Adolesc Psychiatry. 2006; 45(3): 298304.CrossRefGoogle ScholarPubMed
19.Biederman, J, Joshi, G, Mick, E, etal. A prospective open-label trial of lamotrigine monotherapy in children and adolescents with bipolar disorder. CNS Neurosci Ther. 2010; 16(2): 91102.CrossRefGoogle ScholarPubMed
20.Soutullo, CA, Díez-Suárez, A, Figueroa-Quintana, A. Adjunctive lamotrigine treatment for adolescents with bipolar disorder: retrospective report of five cases. J Child Adolesc Psychopharmacol. 2006; 16(3): 357364.CrossRefGoogle ScholarPubMed
21.Patel, NC, DelBello, MP, Bryan, HS, etal. Open-label lithium for the treatment of adolescents with bipolar depression. J Am Acad Child Adolesc Psychiatry. 2006; 45(3): 289297.CrossRefGoogle ScholarPubMed
22.Poznanski, EO, Freman, LN, Mokros, HB. Children's Depression Rating Scale–Revised. Psychopharmacol Bull. 1985; 21: 979989.Google Scholar
23.Spearing, MK, Post, RM, Leverich, GS, etal. Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res. 1997; 73(3): 159171.CrossRefGoogle Scholar
24.Biederman, J, Mick, E, Spencer, TJ, etal. Therapeutic dilemmas in the pharmacotherapy of bipolar depression in the young. J Child Adolesc Psychopharmacol. 2000; 10(3): 185192.CrossRefGoogle ScholarPubMed
25.Desarkar, P, Bakhla, A, Sinha, VK. Duloxetine-induced ultrarapid cycling in an adolescent with bipolar depression. J Clin Psychopharmacol. 2007; 27(1): 115116.CrossRefGoogle Scholar
26.Goldsmith, M, Singh, M, Chang, K. Antidepressants and psychostimulants in pediatric populations: is there an association with mania? Pediatr Drugs. 2011; 13(4): 225243.CrossRefGoogle ScholarPubMed
27.Gracious, BL, Chirieac, MC, Costescu, S, etal. Randomized, placebo-controlled trial of flax oil in pediatric bipolar disorder. Bipolar Disord. 2010; 12(2): 142154.CrossRefGoogle ScholarPubMed
28.Feeny, NC, Danielson, CK, Schwartz, L, etal. Cognitive-behavioral therapy for bipolar disorders in adolescents: a pilot study. Bipolar Disord. 2006; 8(5): 508515.CrossRefGoogle ScholarPubMed
29.Goldstein, TR, Axelson, DA, Birmaher, B, etal. Dialectical behavior therapy for adolescents with bipolar disorder: a 1-year open trial. J Am Acad Child Adolesc Psychiatry. 2007; 46(7): 820830.CrossRefGoogle ScholarPubMed
30.Fristad, MA, Verducci, JS, Walters, K, etal. Impact of multifamily psychoeducational psychotherapy in treating children aged 8 to 12 years with mood disorders. Arch Gen Psychiatry. 2009; 66(9): 10131021.CrossRefGoogle ScholarPubMed
31.Young, RC, Biggs, JT, Ziegler, VE, etal. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978; 133: 429435.CrossRefGoogle ScholarPubMed