Gianni L. Faedda, MD, Ross J. Baldessarini, MD,
Trisha Suppes, MD, PhD, Leonardo Tondo, MD, Ina Becker, MD,
and Deborah S. Lipschitz, MD
(Harvard Rev Psychiatry 1995;3:171-95.)
Contemporary diagnostic challenges
Presentation versus age of onset
Age of onset
Premorbid characteristics and precipitants
Type of onset
Alternative mood stabilizing treatments
Comment and conclusions
Complex and Rapid Cycling in Bipolar Children and Adolescents:
A Preliminary Study
by Barbara Geller, M.D.; Kai Sun, Ph.D.; Betsy Zimerman, M.A.; Joan Luby, M.D.; Jeanne Frazier, B.S.N.; Marlene Williams, R.N.
Twenty-six subjects aged 7-18 years old were studied. Diagnoses of bipolar disorders were established using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present Episode Version-1986 modified for DSM-III-R criteria and for rating the number and duration of manic and hypomanic episodes. Complex cycling patterns were observed. These included numerous, brief episodes suggesting continuous, rapid-cycling in 80.8% of cases. Mean age of onset was early (8.5±4.4 years). Psychotic phenomena, suicidality, hyperactivity, and "mixed mania" were highly prevalent. Data in this report provide support for complex and rapid-cycling patterns in childhood onset BP.