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The Balanced Mind Parent Network Expert Chat with Ellen Leibenluft, M.D., of NIMH

Nanci - The Balanced Mind Parent Network 
I'm very pleased to introduce our guest expert today, Dr. Ellen Leibenluft. Dr. Leibenluft received her B.A. from Yale University in 1974 and an M.D. from Stanford University in 1978. After completing residency training at Georgetown University Hospital, she served on the faculty there as director of the psychiatric inpatient unit and day hospital. She then came to the NIMH, where she conducted research on bipolar disorder. In particular, her publications focus on rapid cycling bipolar disorder (a severe form of the illness) and on the role of the sleep-wake cycle in the illness. She has also written and spoken widely on gender differences in the prevalence and symptomatology of mood disorders. She is now actively involved in research on bipolar disorder in children and adolescents, with a particular emphasis on differences between children and adults in the presentation of the illness; neural mechanisms underlying the symptoms of the illness; and the development of new treatment strategies for early-onset bipolar disorder.

Nanci - The Balanced Mind Parent Network 
Dr. Leibenluft, would you like to start out by talking about the research that you are doing with the NIMH?

Dr. Ellen Leibenluft

First, I want to say that it’s a pleasure to be here "chatting" with you all. Our research is focused on the brain mechanisms that underlie bipolar disorder in children, and also very severe irritability. We hope that these studies will move us closer to better treatments and even prevention of the illness. We are also interested in children with have a sibling or parent with bipolar disorder, and therefore are at risk for the illness. 

Geared Towards:

Bipolar Disorder in Children Appears More Severe Than In Most Adults

Child psychiatry researchers from Washington University School of Medicine in St. Louis report that bipolar disorder, formerly called manic-depressive illness, can occur in children as young as 7 years old and that the illness in young bipolar children resembles the most severe form of bipolar disorder in adults.

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Early and Late Bipolar Disorders: Different Forms of Manic-Depressive Illness?

Research report that addresses what differences the age of onset of the disorder means in terms of severity of the illness. Early onset generally means that the illness is more severe overall, with greater familial risk.  Early onset indicates more psychosis, greater comorbidity with panic disorder and poorer response to lithium treatment.

Geared Towards:

Pediatric Mania: A Developmental Subtype of Bipolar Disorder?

by Joseph Biederman, Eric Mick, Stephen V. Faraone, Thomas Spencer, Timothy E. Wilens, and Janet Wozniak

Reproduced by permission of Elsevier Science from Biological Psychiatry, Vol. No. 48, pages 458-466, Copyright 2000 by the Society of Biological Psychiatry.

Despite ongoing controversy, the view that pediatric mania is rare or nonexistent has been increasingly challenged not only by case reports, but also by systematic research. This research strongly suggests that pediatric mania may not be rare but that it may be difficult to diagnose. Since children with mania are likely to become adults with bipolar disorder, the recognition and characterization of childhood-onset mania may help identify a meaningful developmental subtype of bipolar disorder worthy of further investigation.

Geared Towards:

Is Bipolar Disorder Still Underdiagnosed? Are Antidepressants Overutilized?

Research report that reviews frequency of bipolar diagnosis in patients with mood disorders and the prescription of antidepressants as treatment.

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