[Case series with childhood bipolar disorder phenotype features]

Although outcomes of bipolar disorder with onset in late adolescence and adulthood have been reported, little is known about childhood and prepubertal onset mania. There is a considerable overlap between the diagnostic criteria for mania and disruptive behavioral disorders, particularly attention deficit hyperactivity disorder (ADHD). The overlapping diagnostic boundaries need to be described. We aimed to determine the frequency and severity of symptoms and cycling features in our patients. We reported 7 cases (between 7 and 15 years old) with bipolar phenotype features who were being followed in our unit. The Washington University at St. Louis-Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia-Present state and lifetime-B. Geller et al.1996 (WASH-U-KSADS) was used for the assessment of psychiatric diagnoses and symptomatology. The Turgay DSM-IV Disruptive Behaviour Disorders Scale was used to determine the frequency of comorbidity between ADHD symptoms and bipolar disorder phenotype features. The most frequent severe symptoms observed at the end of the assessment by WASH-U-KSADS were grandiosity, distractibility, and unusual energy. Four of the cases had mixed cycling features. Five of the cases had ultradian cycling features. All these findings suggest that more research should be carried out on psychosocial and psychopharmacological strategies and pathogenetic mechanisms for mania during the prepubertal and early adolescent years.