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Study: Bipolar Disorder Harder on Youngsters

bipolar disorder and childrenBipolar disorder is a more severe illness for children than adults during the first few years after diagnosis, a landmark study suggested Monday.

The first research tracking a large group of bipolar children and teenagers over time finds that 2 years after diagnosis:

Nearly one-third of them still have not recovered.

It takes the rest about 17 months to recover.

Four out of five have at least one recurrence.

During the study, children experienced serious symptoms about two-thirds of the time, says study leader Boris Birmaher of the University of Pittsburgh Medical School. "They spend more time ill than adults with the same disease."

 

The study of 300 children ages 7 to 18 was released at the American Psychiatric Association meeting in Atlanta.

A key hurdle to healing is that children cycle through manic and depressed moods much more rapidly than adults, which makes it tough to keep them on the right medication, Birmaher says. Children averaged 16 cycles of mood changes a year; adults have 3 changes

"Some kids do well nonetheless," he says. "But it's a difficult disease to treat."

There are no solid figures on how many children and teens have bipolar disease, or manic depression. About 1% of adults, 2 million Americans, have the illness, says the National Institute of Mental Health. It has a strong genetic link, but not all cases are genetic. Less is known about the disease in children.

The bleak portrait painted by Birmaher "unfortunately rings true for parents around the country," says Lisa Pedersen, research chair of the Child and Adolescent Bipolar Foundation, a non-profit education and support group (www.bpkids.org).

If anything, the problem could be understated; the study defines recovery as at least 8 consecutive weeks with minimal or no symptoms. "I don't know any parent who would term 8 weeks a recovery," Pedersen says.

Children with bipolar disorder often are misdiagnosed with ADHD or other behavior problems, which delays proper treatment, Petersen adds. And stimulants or antidepressants can worsen their symptoms.

On the other hand, as awareness of the disease grows, more with ADHD are misdiagnosed as bipolar, says Lori Altshuler of the UCLA Neuropsychiatric Institute, who specializes in manic depression.

About 15% of adults have the "rapid cycling" form of the disease more common in children, "and that's the most difficult to treat in adults," she says. A few newer anti-convulsive drugs are showing promise in adults, but they have not been tested in kids, Altshuler says. The new evidence on children "creates a pressure to find more drugs that work well in the rapid cycling disease."

By Marilyn Elias, USA TODAY  5/23/05             

 Warning Signs:

A few key signs that a child might have bipolar disorder:

A typical, severe mood swings from super-happy or silly to terribly sad.

Little need for sleep, perhaps only a few hours a night, but not tired the next day.

Sexual acting-out when there has been no sexual abuse or exposure to sexually explicit material.

Expressing grandiose ideas, such as claiming to be a math genius.

Source:
Boris Birmaher, New Hope for Children and Teens with Bipolar Disorder

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