Bipolar Disorder in Childhood and Early Adolescence

Article excerpt

BARBARA GELLER AND MELISSA P. DELBELLO (Eos.): Bipolar Disorder in Childhood and Early Adolescence. Guilford Press, New York, 2003, 342 pp., $36.00, ISBN 1-57230-837-0.

There has been substantial controversy in the mental health field about the existence and diagnostic boundary of childhood (i.e., early-onset) bipolar disorder. Although it is now accepted that symptoms of mania can be manifested in children and adolescents (see National Institute of Mental Health Research Roundtable on Prepubertal Bipolar Disorder, 2001, Journal of the American Academy of Child and Adolescent Psychiatry, 40, 871-878), many questions remain about the diagnosis, natural history, neurobiology, and treatment of early-onset bipolar disorder. The book Bipolar Disorder in Childhood and Early Adolescence is an edited collection of 15 chapters that address these questions as well as a range of other aspects of early-onset bipolar disorder. The authors of the chapters are established scientists whose work in this area is recognized as "state of the art."

The first 4 chapters of the book address the diagnosis and phenomenology of bipolar disorder in children and adolescents. In chapter 1, Peter Lewinsohn and his colleagues describe the epidemiology, clinical characteristics, and longitudinal course of early adolescent bipolar disorder. Chapter 2, by Barbara Geller and her colleagues, discusses a recently developed diagnostic instrument for pediatrie bipolar research and presents data that help to clarify the diagnostic boundary between attention deficit/hyperactivity disorder (ADHD) and early-onset bipolar disorder. In chapter 3, Sandra Dejong and Jean Frazier review phenomenological characteristics, diagnostic issues, and pharmacological treatments for children and adolescents with co-occurring pervasive developmental disorders and early-onset bipolar disorder. Chapter 4, by Demitri Papolos, examines the common comorbidities (e.g., ADHD, conduct disorder, substance use disorder) associated with early-onset bipolar disorder. In chapter 5, Kiki Chang and Hans Steiner review studies about offspring of parents with bipolar disorder and describe early manifestations of bipolar disorder in children.

The second section of this book discusses the genetic, biological, and neurological causes and correlates of early-onset bipolar disorder. Chapter 6, by Nuri Farber and John Newcomer, examines how problems in brain maturation and development might lead to abnormalities in neuronal functioning that underlie symptoms of bipolar disorder. In chapter 7, Melissa DelBello and Robert Kowatch review data from neuroimaging studies (e.g., computed tomography, magnetic resonance imaging, single-photon emission computed tomography) and conclude that children and adolescents with bipolar disorder exhibit frontal-subcortical brain abnormalities. In chapter 8, Robinder Bhangoo and her colleagues discuss the physiological correlates of emotion that are especially relevant to early-onset bipolar disorder. Chapter 9, by Ohel Soto and Tanya Murphy, uses the example of pédiatrie autoimmune neuropsychiatrie disorders associated with streptococcus (PANDAS) to explain how immune system dysfunction can produce psychiatric symptoms, including mania and depression. In chapter 10, Uma Rao discusses EEG sleep pattern disruptions underlying bipolar disorder and suggests possible mechanisms (e.g., circadian dysregulation) related to these disruptions. …