期刊名称：Journal of Indian Association for Child and Adolescent Mental Health
电子版ISSN：0973-1342
出版年度：2012
卷号：8
期号：1
页码：1-5
出版社：Indian Association for Child and Adolescent Mental Health
摘要：About two thirds of adult bipolar disorder (BPD) patients report onset of bipolarity inchildhood and adolescence [1]. The earlier the age of onset, the greater the risk ofrecurrence, functional impairment and chronicity of mood symptoms [2]. An influentialpaper in mid nineties suggested that juvenile mania had an insidious onset and ran achronic course [3]. Mixed episode was most common presentation, dominated by severeirritability and affective storms. 70% of patients had an onset <5 years of age. Despitebeing chronically manic, it was reported that juvenile mania was frequently comorbidwith attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder(ODD), conduct disorder (CD) and anxiety disorders [3]. Their school of thoughtemphasized the centrality of irritability in establishing the diagnosis and recommenddiagnosing BPD if the child meets DSM-IV criteria with irritability as a core symptom,even in the absence of elation, grandiosity, and episodicity [3,4]. This was followed by anexplosion in literature on paediatric BPD. Research groups differed in viewing paediatricBPD as an insidious onset chronic disorder characterized by irritability without elation orgrandiosity and highly comorbid with disruptive behavioural disorder (DBD). Someresearchers considered irritability to be a core criterion only if it co-occurs with elatedmood or grandiosity [5-7]. Indian studies differed from western studies and reportedclassical episodic BPD with much lower rates of comorbid DBD
