New Developments in Bipolar Spectrum Disorders in Children and Adolescents

One of the most challenging areas of psychiatry is the diagnosis and management of children and adolescents with bipolar
spectrum disorders. It is estimated that there are up to 2 million children and adolescents in the United States with bipolar
disorder or prodromal manifestations. In the past decade there has been a significant increase in diagnoses of bipolar disorder
among those under 18 years of age. Although it is unclear why diagnoses are increasing, it is now appreciated that about half
of adult patients diagnosed with bipolar disorder had their first episode as children or adolescents. Differential diagnosis is
challenging and as many as half of adolescents with bipolar disorder are misdiagnosed. In particular, recognition of the
depressive phase of the bipolar spectrum disorders in children and adolescents remains an unmet need. It is estimated that
young persons with bipolar disorder spend about 40% of the time with depressive symptoms. Depressive episodes in
bipolar disorder present a number of challenges as symptoms in youth vary and are often atypical. While there are data on
pharmacologic management of mania in children and adolescents, less is known about the treatment of pediatric bipolar
depression. It is important that psychiatric healthcare providers recognize pediatric bipolar depression earlier and initiate
appropriate management interventions. In this activity, expert faculty will discuss clinical strategies to enhance the
accurate diagnosis of bipolar disorder in children and adolescents, management of comorbidities, and contemporary
approaches to treatment.