Bipolar disorder in children

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Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a rare mental disorder in children and adolescents. The diagnosis of bipolar disorder in children has been heavily debated for many reasons including the potential harmful effects of adult bipolar medication use for children. PBD is similar to bipolar disorder (BD) in adults, and has been proposed as an explanation for periods of extreme shifts in mood called mood episodes.^[1][2] These shifts alternate between periods of depressed or irritable moods and periods of abnormally elevated moods called manic or hypomanic episodes.^[1] Mixed mood episodes can occur when a child or adolescent with PBD experiences depressive and manic symptoms simultaneously.^[2] Mood episodes of children and adolescents with PBD are different from general shifts in mood experienced by children and adolescents because mood episodes last for long periods of time (i.e. days, weeks, or years) and cause severe disruptions to an individual's life.^[2] There are three known forms of PBD: Bipolar I, Bipolar II, and Bipolar Not Otherwise Specified (NOS).^[2] The average age of onset of PBD remains unclear, but reported age of onset ranges from 5 years of age to 19 years of age.^[3] PBD is typically more severe and has a poorer prognosis than bipolar disorder with onset in late-adolescence or adulthood.^[4]

Since 1980, the DSMTooltip Diagnostic and Statistical Manual of Mental Disorders has specified that the criteria for bipolar disorder in adults can also be applied to children with some adjustments based on developmental differences.^[5] Genetics and environment are considered risk factors for the development of bipolar disorder with the exact cause unknown at this time. Therefore, diagnosis of bipolar disorder requires evaluation by a professional and diagnosis of PBD typically requires more in depth observation due to children's inability to properly report symptoms.