Progress in diagnosis and treatment of bipolar disorder among children and adolescents: an international perspective

2018 ◽  
Vol 21 (4) ◽  
pp. 177-181 ◽  
Author(s):  
Robert L Findling ◽  
Ekaterina Stepanova ◽  
Eric A Youngstrom ◽  
Andrea S Young
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Evidence Base ◽  
International Perspective ◽  
Current Data ◽  
Diagnosis And Treatment ◽  
Pharmacological Agents ◽  
Course Of Illness ◽  
History Of ◽  
Made In

Bipolar disorder (BPD) is a potentially lifelong condition characterised by extreme changes in mood that may begin in childhood and cause substantial impairment. Over the past decades, BPD has been the focus of increased attention mainly due to controversies surrounding its prevalence, diagnosis and treatment in children and adolescents. This report addresses these controversies by reviewing the extant evidence base, providing clinicians with a summary of the literature on diagnosis, phenomenology and treatment of paediatric BPD. The debate regarding diagnosing children with BPD based on severe irritability and aggression is mostly resolved. The current data support utilising the diagnostic criteria based on episodic changes of mood polarity. Therefore, longitudinal course of illness should be explored in detail when diagnosing BPD. Given high rates of genetic predisposition for BPD, assessment of youth should focus on obtaining accurate family history of this condition. Additionally, there has been a substantial increase in randomised placebo-controlled clinical trials evaluating pharmacological agents for mood stabilisation in children and adolescents, which we summarise in this review. Despite significant progress being made in the field of paediatric BPD, more research is needed in the areas of phenomenology, pathophysiology, course and treatment of this condition in youth.

scholarly journals Ten Percent of SIDS Cases are Murder — or are They?

2017 ◽  
Vol 7 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Christopher M. Milroy ◽  
Charis Kepron
Keyword(s):  
Sudden Infant Death ◽  
Current Data ◽  
Related Question ◽  
Sudden Infant ◽  
Court Cases ◽  
Unexpected Death ◽  
Infant Deaths ◽  
Lower Figure ◽  
History Of ◽  
Made In

Sudden infant death syndrome (SIDS) has been used as a cause of death for over four decades. It has allowed deaths of infants to be registered as natural. Within this group of deaths, a certain number have been recognized to be homicides from inflicted smothering rather than being natural or accidental deaths. Research has been conducted using confidential inquires to determine how frequent homicide is in cases called SIDS. This paper traces the history of quoted rates of homicide. Early work suggested the figure was between 2-10% of all SIDS cases, though other workers have suggested figures as high as 20-40%. With the fall in the rate of infant deaths following the “Back to Sleep” campaigns, these figures have been reevaluated. If the higher figures were correct that 20-40% of SIDS were homicides, the fall in infant deaths would be expected to be less than it has been. Current data suggests a much lower figure than 10% of current cases, with much lower overall rates of infant deaths. As well as 10% of SIDS cases having been stated to be homicides, a related question is whether multiple deaths classified as SIDS are really homicides. The paper discusses the maxim that one death is a tragedy, two is suspicious, and three deaths indicate homicide. The paper also looks at court cases and the approach that has been made in prosecutions of sudden unexpected death in infancy as multiple murder.

Mood Disorders

2017 ◽  
Author(s):  
Hasan A Baloch ◽  
Jair C. Soares
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Gray Matter ◽  
Affective Disorders ◽  
Unipolar Depression ◽  
Diagnosis And Treatment ◽  
Bipolar Spectrum ◽  
Manic Symptoms ◽  
Lifetime History ◽  
History Of

Affective disorders are among the most common disorders in psychiatry. They are generally classified according to the persistence and extent of symptoms and by the polarity of these symptoms. The two poles of the affective spectrum are mania and depression. Bipolar disorder is characterized by the presence of the mania or hypomania and often depression. Unipolar depression is defined by depression in the absence of a lifetime history of mania or hypomania. These differences are not merely categorical but have important implications for the prognosis and treatment of these conditions. Bipolar disorder, for example, is better treated using mood-stabilizing medication, whereas unipolar depression responds optimally to antidepressant medications. In addition, prognostically, unipolar depression may sometimes be limited to one episode in a lifetime, whereas bipolar disorder is typically a lifelong condition. The course of both conditions, however, is often chronic, and frequently patients can present with unipolar depression only to later develop manic symptoms. A thorough understanding of both conditions is therefore required to treat patients presenting with affective symptomatology. This chapter discusses the epidemiology, etiology and genetics, pathogenesis, diagnosis, and treatment of unipolar depression and bipolar disorder. Figures illustrate gray matter differences with lithium use and the bipolar spectrum. Tables list the pharmacokinetics of commonly used antidepressants and medications commonly used in the treatment of bipolar disorder. This review contains 2 figures, 2 tables, and 136 references.

scholarly journals Pharmacological treatment of depression and bipolar disorder in children and adolescents

2010 ◽  
Vol 16 (6) ◽  
pp. 402-412 ◽  
Author(s):  
Bernadka Dubicka ◽  
Paul Wilkinson ◽  
Raphael G. Kelvin ◽  
Ian M. Goodyer
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Treatment Guidelines ◽  
Evidence Base ◽  
Current Treatment ◽  
Risks And Benefits ◽  
Treatment Of Depression ◽  
Increased Risk ◽  
Potential Risks ◽  
Considerable Morbidity

SummaryMajor depression and bipolar disorder in children and adolescents are serious conditions associated with considerable morbidity as well as increased risk of suicide. The treatment of depression in young people is currently controversial and this article reviews the evidence base and potential risks and benefits of antidepressants. Although the diagnosis of bipolar disorder is also controversial, medication is the first-line treatment of choice in cases that meet diagnostic criteria. The limited evidence base in children and adolescents is presented, along with current treatment guidelines. Despite the controversies in this field, this article concludes that medication remains an important part of the treatment approach for both disorders, although the risks and benefits of pharmacotherapy need to be carefully assessed in each patient.

ADHD and bipolar disorder challenge in diagnosis in children and adolescents

2016 ◽  
Vol 33 (S1) ◽  
pp. S347-S347
Author(s):  
P. Cano Ruiz ◽  
A. Gómez Peinado ◽  
S. Cañas Fraile ◽  
P. Sanmartin Salinas
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Attention Deficit Disorder ◽  
Psychiatric Symptoms ◽  
Family Factors ◽  
Bipolar Spectrum ◽  
Hyperactivity Disorder ◽  
Bipolar Disease ◽  
History Of ◽  
Competing Interest

IntroductionThe professionals in charge of children and adolescents with attention deficit disorder and hyperactivity disorder (ADHD) should be prepared to treat a wide variety of psychiatric symptoms, as most have at least one comorbid psychiatric disorder.Sometimes the differential diagnosis between ADHD and bipolar disease is difficult because of overlapping symptoms between the two disorders (Geller et al., 1997; Biederman et al., 2000; Singh et al., 2006).MethodologyA literature review about the comorbidity between ADHD and bipolar disorder in children and adolescents was performed.ResultsAccording to different studies, between 60 and 90% of children and adolescents with ADHD have comorbid bipolar disorder. However, the percentage of children and adolescents with ADHD that has comorbid bipolar disorder varied from 10 to 22% (puedes poner from 60 to 90% si no quieres repetir el and).ConclusionsThe prevalence of bipolar disease, particularly among adolescents, is between 1 and 7%. This percentage is higher if all forms of bipolar spectrum are included. Some personal and family factors increase the probability of a patient having ADHD present bipolar disease: decreased IQ, delayed development, family history of ADHD or bipolar disease, and the combined subtype.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The history of paediatric cardiology on stamps

2017 ◽  
Vol 28 (1) ◽  
pp. 1-8
Author(s):  
Hazım A. Gursu ◽  
Ibrahim I. Cetin
Keyword(s):  
Magnetic Resonance ◽  
Extracorporeal Circulation ◽  
Imaging Techniques ◽  
Disease Diagnosis ◽  
Diagnosis And Treatment ◽  
Paediatric Cardiology ◽  
The Past ◽  
History Of ◽  
Past Half ◽  
Made In

AbstractPaediatric cardiology is arguably the sub-specialty in which the greatest advances have been made in both disease diagnosis and treatment over the past half a century. Paediatric cardiology emerged as a discipline in the 1930s. Since then, advances in imaging techniques such as echocardiography, angiography, CT, or magnetic resonance and extracorporeal circulation have provided excellent diagnosis and treatment of CHD. The pioneers of paediatric cardiology are more than eponyms, for each used in new and original ways the tools and concepts available in his or her era. This brief overview of the history of paediatric cardiology on stamps begins from William Harvey up to our own time, and includes the milestones in paediatric cardiology.

scholarly journals Interhemispheric white matter integrity in young people with bipolar disorder and at high genetic risk

2016 ◽  
Vol 46 (11) ◽  
pp. 2385-2396 ◽  
Author(s):  
G. Roberts ◽  
W. Wen ◽  
A. Frankland ◽  
T. Perich ◽  
E. Holmes-Preston ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Young People ◽  
Age Of Onset ◽  
Familial Risk ◽  
The Novel ◽  
Course Of Illness ◽  
High Genetic Risk ◽  
History Of ◽  
Recurrent Major Depressive Disorder

BackgroundWhite matter (WM) impairments have been reported in patients with bipolar disorder (BD) and those at high familial risk of developing BD. However, the distribution of these impairments has not been well characterized. Few studies have examined WM integrity in young people early in the course of illness and in individuals at familial risk who have not yet passed the peak age of onset.MethodWM integrity was examined in 63 BD subjects, 150 high-risk (HR) individuals and 111 participants with no family history of mental illness (CON). All subjects were aged 12 to 30 years.ResultsThis young BD group had significantly lower fractional anisotropy within the genu of the corpus callosum (CC) compared with the CON and HR groups. Moreover, the abnormality in the genu of the CC was also present in HR participants with recurrent major depressive disorder (MDD) (n = 16) compared with CON participants.ConclusionsOur findings provide important validation of interhemispheric abnormalities in BD patients. The novel finding in HR subjects with recurrent MDD – a group at particular risk of future hypo/manic episodes – suggests that this may potentially represent a trait marker for BD, though this will need to be confirmed in longitudinal follow-up studies.

Mood Disorders

2010 ◽  
Author(s):  
Hasan A Baloch ◽  
Jair C. Soares
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Gray Matter ◽  
Affective Disorders ◽  
Unipolar Depression ◽  
Diagnosis And Treatment ◽  
Bipolar Spectrum ◽  
Manic Symptoms ◽  
Lifetime History ◽  
History Of

Affective disorders are among the most common disorders in psychiatry. They are generally classified according to the persistence and extent of symptoms and by the polarity of these symptoms. The two poles of the affective spectrum are mania and depression. Bipolar disorder is characterized by the presence of the mania or hypomania and often depression. Unipolar depression is defined by depression in the absence of a lifetime history of mania or hypomania. These differences are not merely categorical but have important implications for the prognosis and treatment of these conditions. Bipolar disorder, for example, is better treated using mood-stabilizing medication, whereas unipolar depression responds optimally to antidepressant medications. In addition, prognostically, unipolar depression may sometimes be limited to one episode in a lifetime, whereas bipolar disorder is typically a lifelong condition. The course of both conditions, however, is often chronic, and frequently patients can present with unipolar depression only to later develop manic symptoms. A thorough understanding of both conditions is therefore required to treat patients presenting with affective symptomatology. This chapter discusses the epidemiology, etiology and genetics, pathogenesis, diagnosis, and treatment of unipolar depression and bipolar disorder. Figures illustrate gray matter differences with lithium use and the bipolar spectrum. Tables list the pharmacokinetics of commonly used antidepressants and medications commonly used in the treatment of bipolar disorder. This review contains 2 figures, 2 tables, and 135 references.

scholarly journals Bipolar Disorder in Children

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Kimberly Renk ◽  
Rachel White ◽  
Brea-Anne Lauer ◽  
Meagan McSwiggan ◽  
Jayme Puff ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Preschool Children ◽  
Health Service ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Service Providers ◽  
Health Service Providers ◽  
Assessment And Treatment ◽  
History Of ◽  
Assessment Strategies

Although bipolar disorder historically was thought to only occur rarely in children and adolescents, there has been a significant increase in children and adolescents who are receiving this diagnosis more recently (Carlson, 2005). Nonetheless, the applicability of the current bipolar disorder diagnostic criteria for children, particularly preschool children, remains unclear, even though much work has been focused on this area. As a result, more work needs to be done to further the understanding of bipolar symptoms in children. It is hoped that this paper can assist psychologists and other health service providers in gleaning a snapshot of the literature in this area so that they can gain an understanding of the diagnostic criteria and other behaviors that may be relevant and be informed about potential approaches for assessment and treatment with children who meet bipolar disorder criteria. First, the history of bipolar symptoms and current diagnostic criteria will be discussed. Next, assessment strategies that may prove helpful for identifying bipolar disorder will be discussed. Then, treatments that may have relevance to children and their families will be discussed. Finally, conclusions regarding work with children who may have a bipolar disorder diagnosis will be offered.

Bipolar disorder in children and adolescents: international perspective on epidemiology and phenomenology

2005 ◽  
Vol 7 (6) ◽  
pp. 497-506 ◽  
Author(s):  
Cesar A Soutullo ◽  
Kiki D Chang ◽  
Azucena Diez-Suarez ◽  
Ana Figueroa-Quintana ◽  
Inmaculada Escamilla-Canales ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
International Perspective
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