ERIC Number: EJ698930
Record Type: Journal
Publication Date: 2005-Aug-1
Reference Count: N/A
Children with a Prepubertal and Early Adolescent Bipolar Disorder Phenotype from Pediatric Versus Psychiatric Facilities
Tillman, Rebecca; Geller, Barbara; Frazier, Jeanne; Beringer, Linda; Zimerman, Betsy; Klages, Tricia; Bolhofner, Kristine
Journal of the American Academy of Child and Adolescent Psychiatry, v44 n8 p776-781 Aug 2005
Objective: To examine characteristics between subjects with a prepubertal and early adolescent bipolar disorder phenotype from pediatric versus psychiatric venues. Method: Subjects (N = 93) with a prepubertal and early adolescent bipolar disorder phenotype were obtained through consecutive new case ascertainment from designated pediatric and psychiatric sites from 1995 to 1998. Children needed DSM-IV bipolar I disorder (manic or mixed phase) with elation and/or grandiosity as one criterion to avoid diagnosing mania only by symptoms that overlapped with those of attention-deficit/hyperactivity disorder. Comprehensive assessment included the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia, given separately to parents about their children and to children about themselves by experienced research nurses blinded to subjects' diagnostic status. Results: Rates of mixed mania ([chi square] = 7.1, p = .008) and suicidality ([chi square] = 7.2, p = .007) were significantly higher at psychiatric versus pediatric venues. Subjects from pediatric sites were significantly more likely to be living with their intact biological family ([chi square] = 5.3, p = .022). Significantly more subjects with a prepubertal and early adolescent bipolar disorder phenotype ascertained at psychiatric sites versus pediatric sites were taking an antimanic medication ([chi square] = 9.5, p = .002), while stimulant medication was significantly more common among subjects ascertained at pediatric sites ([chi square] = 19.0, p < .0001). Conclusions: These pediatric versus psychiatric site differences suggest that pediatricians may underrecognize mania and thus do not prescribe antimanic mood-stabilizing medications. Moreover, pediatricians may be more likely to refer children to psychiatrists when depression or suicidality is evident.
Descriptors: Preadolescents, Student Characteristics, Symptoms (Individual Disorders), Early Adolescents, Clinical Diagnosis, Psychiatry, Pediatrics, Hyperactivity, Depression (Psychology)
Lippincott Williams & Wilkins, P.O. Box 1620, Hagerstown, MD 21741. Tel: 800-638-3030 (Toll Free); Fax: 301-223-2400.
Publication Type: Journal Articles
Education Level: N/A
Authoring Institution: N/A
Identifiers - Location: Washington