Clinical presentations of bipolar disorder in children and adolescents

Objective: To describe clinical presentations of bipolar disorder in children and adolescents when they were diagnosed. Material and Method: The present study was a retrospective chart review of patients who were diagnosed bipolar disorder when they were under 19 years of age. All subjects, both inpatients and outpatients, received psychiatric treatment at Ramathibodi hospital between January 1998 and May 2008. Results: Forty-nine subjects aged between eight and 18-years-old (mean 15.3 years) were diagnosed as bipolar disorder. Thirty-seven percent of patients had cardinal symptoms including elevated mood and/or grandiosity. Being talkative was the most common associated symptom, found in 47% of patients. Psychotic symptoms were found in 39% of patients. Moreover, 27% of patients suffered from suicidal idea or had attempted suicide at the time of diagnostic. Conclusion: Although there is very limited information about clinical presentations of bipolar disorder in children and adolescents, especially in Thai population, the author found that only 37% of these patients presented with cardinal symptoms at the time of diagnosis.