Lithium carbonate treatment of select behavior disorders in children suggesting manic-depressive illness

Twelve children with severe chronic behavior disorders who benefited from treated with lithium carbonate over an extended period of time (6 to 33 months) are described. Behavioral features common to all included hostility, aggressiveness, and distractibility. Nine had cyclic mood swings, with periods of withdrawal and periods of manic excitement; six of these had neurovegetative disorders. These nine children may have manic-depressive disease of childhood. Three children had no cyclic symptoms, though their hostile and aggressive behavior was similar to that of the cyclic group; they responded similarly to lithium. Family histories were strongly positive for manic-depressive disease, depression, and alcoholism. A double-blind placebo-controlled crossover study in four patients supported the specific behavioral effect of lithium.