June 26, 2009

Irritability part of kid bipolar disorder

U.S. researchers say irritability should be considered when diagnosing bipolar disorder in children.

The study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, found a small percentage of children with bipolar disorder experience manic episodes without extreme elation -- one of the hallmarks of the disorder -- and are diagnosed based on irritable mood alone.

Diagnosing children with bipolar disorder is challenging. One of the chief controversies is whether irritability should be included among the criteria for this diagnosis because it can also overlap with a number of other psychiatric disorders, such as attention deficit hyperactivity disorder, lead author Dr. Jeffrey Hunt of Bradley Hospital in Providence, R.I., said in a statement. Our findings confirm that while irritable-only mania is uncommon, it does exist -- particularly in younger children -- and should be considered in a bipolar diagnosis.

In collaboration with researchers at the University of Pittsburgh and the University of California, Los Angeles, Hunt and colleagues quantified the frequency and severity of manic symptoms -- including irritability and elation -- in 361 children between the ages of 7 and 17 already diagnosed with bipolar disorder who were participating in the multisite Course and Outcome of Bipolar Illness in Youth.

The researchers found 10 percent of children were irritable-only and about 15 percent were elated-only. Nearly three-quarters experienced both elation and irritability, the study said.