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Pharmacotherapy in the community-based treatment of children with bipolar I disorder
1Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA. jjerrell@gw.mp.sc.edu
Objective:
To examine the services and medications received, and psychosocial functioning changes over time of children and adolescents with bipolar I disorder in a public mental health system.
Method:
Medical records were reviewed for 82 patients, 6-17 years of age, diagnosed with bipolar I disorder, and newly admitted to one public mental health system between 1 July 2003 and 30 June 2004. A retrospective cohort design was employed, with an 18-month follow-up period.
Results:
One-third of the patients dropped out treatment within a few months. The psychosocial functioning ratings of patients who remained in treatment improved over time on several dimensions (total, school/work, behavior toward others). Children and adolescents prescribed both a mood stabilizer and an atypical antipsychotic medication regimen (35%) were rated as higher functioning on self-harm behavior and mood/emotions by clinical staff, but their improvement could not be attributed directly to the pharmacotherapy in this small cohort.
Conclusion:
Community-based pharmacotherapy for children and adolescents with bipolar I disorder does not differ substantially from the extant literature, given the complexity and severity of these cases, and may lead to improvement for children and adolescents who remain in treatment.
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