New Treatment Guidelines for Bipolar Children
Careful Diagnosis, Psychiatric Drugs, and Therapy Can Help, Report Shows
WebMD News Archive
More Pediatric Bipolar Diagnoses continued...
McClellan, a member of the psychiatry department at Seattle's University of
Washington, did not work on the guidelines. In his editorial, he calls the
project "laudable" given the "considerable controversy" about
pediatric bipolar disorder.
The guidelines only apply to children aged 6 and older. That's commendable,
says McClellan's editorial. "There is no valid justification for diagnosing
bipolar disorder in preschoolers," he writes. "Labelling severe
tantrums in toddlers as major mental illness lacks face validity and undermines
credibility in our profession."
How to Distinguish Misbehavior From Mental Illness
The guidelines call for careful diagnosis to separate normal childhood
antics and misbehavior from true bipolar disorder, in which patients experience
bouts of mania and depression. The child and at least one parent are needed to
assess the child's mental health.
Frequency, intensity, number, and duration of symptoms -- "FIND,"
for short -- are important.
They say that for example, a child who becomes silly and giggly to a
noticeable or bothersome degree for 30 minutes twice per week has some unusual
behavior, but the frequency, intensity, number of episodes, and duration may
not qualify for a bipolar disorder diagnosis.
It's also important to note the context of the behavior. "Hot, hungry,
stressed, and/or tired children without psychopathology may become
irritable," write the authors.
Likewise, grandiose statements (such as "I am Superman") might not
signal mental illness, depending on the child's age, say the authors in the
When children are diagnosed with bipolar disorder, it's vital that they get
proper care. Medications known as mood-stabilizing drugs, such as lithium, can
help control bipolar disorder. In addition therapy can help, and family
involvement is important, write the authors.
"It is often necessary to use several medications in combination because
these kids are very ill, often suicidal, or too manic and depressed to attend
school," says Kowatch, in a news release. "Stabilizing their moods and
allowing them to return to school as soon as possible is critical if they are
to lead normal lives."