Managing Bipolar Disorders in Adolescents: How Pediatricians Can Help

Criteria for pediatric bipolar disorder, along with treatment options, diagnostic guidance, and collaborative advice for pediatricians, are presented in an American Academy of Pediatrics (AAP) clinical report, “Collaborative Role of the Pediatrician in the Diagnosis and Management of Bipolar Disorder in Adolescents.”

The diagnosis of pediatric bipolar disorder had been made infrequently in adolescents and rarely in young children, the report noted, but the recognized prevalence in both children and adolescents increased dramatically over the past decade, although diagnosis and management remain controversial.

There are 4 types of bipolar disorders, according to the American Psychiatric Association’s classification in The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, all without age restrictions: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder not otherwise specified. The AAP report suggests that pediatricians recognize the changing classification of bipolar and related disorders and collaborate with child and adolescent psychiatrists for a full psychiatric evaluation to confirm a diagnosis.

Bipolar disorder often is associated with manic behaviors, as well as severe depression; psychosis; impairment in social, academic, or occupational functioning; and suicidal thoughts and behaviors, it was noted.

The report encourages pediatricians to collaborate with child and adolescent psychiatrists and other mental health professionals in referring suspected new cases and those with apparent symptom exacerbation, as well as assist in monitoring and managing the adverse effects of medications.

The AAP report was published in Pediatrics and released online.