(3-24-15)
- Bipolar Disorder
- mood disorder affecting 1 to 3.9 % of adult population (Bipolar I & II)
- possibly most heritable major mental disorder
- untreated episodes progressively more severe and treatment resistant
- Bipolar Disorder in Children
- less common: .4 to 1.2% prevalence for any bipolar; BP II, BP NOS, & cyclothymia more common
- most common DSM-IV diagnosis in children: Bipolar Disorder Not Otherwise Specified (because did not meet duration criteria for either BP I or BP II)
- “most comorbid” disorder: 99% of the time there is a second diagnosis
- Modal Child Presentation: ultra-rapid cycling and comorbid ADHD, “rage attacks” most common presenting symptom
- DSM-5 attempts to address the over diagnosis of bipolar disorder in youth (and attendant skyrocketing rates of prescriptions of neuroleptic medications) by introducing new diagnositic category:
- Dysphoric Mood Disregulation Disorder, within the Depressive Disorders grouping
- the impact of this new diagnosis remains to be seen
- Dysphoric Mood Disregulation Disorder, within the Depressive Disorders grouping
- less common: .4 to 1.2% prevalence for any bipolar; BP II, BP NOS, & cyclothymia more common
- Differentiation of PBD and ADHD
- most useful symptoms:
- elevated mood
- grandiosity/inflated self-esteem
- pressured speech
- racing thoughts
- decreased need for sleep
- hypersexuality
- less useful
- bizarre appearance
- lack of insight
- aggression probably most impairing symptom
- highly sensitive
- not very specific
- most useful symptoms: