Reference Room - Index

On-Line Audio and Video Presentations:

The Upside of Down: What We're Learned About Mood Disorders
National Institutes of Health Symposium Videocast

How do we distinguish ordinary sadness, irritability, insomnia, emotional numbness, or even elation from symptoms of clinical depression or bipolar disorder*, particularly in children and teens? What's going on beneath the surface---in the bodies, brains, and daily living experiences of people struggling with and recovering from symptoms of mood disorders? What are scientists accomplishing in the effort to develop new medical and non-pharmaceutical treatments, or effectively identify signs of suicide risk and best ways to intervene?

The National Institute of Mental Health is sponsoring this symposium to update viewers on current findings in the study of mood disorders, which affect nearly 21 million adults in the United States each year. Speakers include NIMH experts Dr. Husseini Manji, Dr. Carlos Zarate, Dr. Ellen Leibenluft, Dr. Jane Pearson, and Dr. David Sommers.  (April 2008)

The Wild Child: Coping with a Bipolar Youth
A WFCR Documentary Special
Produced by award-winning WFCR reporter Karen Brown and edited by John Dankosky of WNPR in Hartford, CT, the show features 3 families (ages 10, 15, and 17), with voices of the children themselves and their parents (speaking over the course of a year). Also interviewed are Martha Hellander, CABF Research Policy Director (and former Executive Director), researchers and child psychiatrists Linda Zamvil, M.D. and Barbara Geller, M.D. (CABF Professional Advisory Council Chair) (discussing differences between adults and children with bipolar disorder, and hypersexual and grandiose behavior), Harry Sarvette, M.D. (a child psychiatrist), Demitri Papolos, M.D. (a psychiatrist) and his wife, Janice (authors of "The Bipolar Child" book), attorney Tammy Selzer of the Bazelon Center discussing school accommodations, and the principal of a therapeutic school where about half of the children are diagnosed with bipolar disorder. (November 2004)

Diagnosis and Treatment of Bipolar Disorder in Children and Adolescents
Dr. Robert Kowatch, One Brain--Many Disorders Web Conference (2001) produced by the Council for Neuroscience Education. (Must have Windows Media Player to hear audio portion of this Web conference. Download Windows Media Player free at http://www.microsoft.com/.)

National Public Radio -- Science Friday
In this hour of Science Friday, guest host Paul Raeburn and guests talk about bipolar disorder in children, why it's difficult to diagnose, and what is available to help treat the condition. Guests on this show include Ellen Liebenluft, M.D. and Mani Pavuluri, M.D. (October 11, 2002)

Bipolar Grand Rounds: New Concepts in Treating Bipolar Disorder
A lecture series for physicians sponsored by UCLA's Neuropsychiatric Institute and hosted by Lori Altshuler, M.D., director, Mood Disorders Research Program, Department of Psychiatry, UCLA medical school.

Neurobiology of Bipolar Disorder: Neuroplasticity and Cellular Resistance
by Husseini Manji, M.D. (2003) Archived on UCLA’s Neuropsychiatric Institute Bipolar Grand Rounds Web site.

Conference Reports:

American Academy of Child & Adolescent Psychiatry, Town Meeting, Washington, DC. (AACAP 2004 Annual Meeting)
Comments by CABF Research Policy Director, Martha Hellander
Hellander praised the recent FDA mandate requiring pharmaceutical companies to add warnings to antidepressants and raised concerns about the monitoring of children who are suicidal or at risk of becoming so.

Pediatric Bipolar Conference, Boston, MA April 2004 (organized by Joseph Biederman, M.D.)

• Report in eBulletin (newsletter) of CABF

American Psychiatric Association 2004 Annual Meeting
New Research on Biological Psychiatry and Pharmacology, Posters and Abstracts.
Includes short descriptions of the new biological psychiatry and pharmacology research that was discussed during the APA's 2004 annual meeting. Medscape requires free registration to view.

American Psychiatric Association 2004 Annual Meeting
New Research on Bipolar Disorder, Posters and Abstracts.
Includes short descriptions of the new bipolar disorder research that was discussed during the APA's 2004 annual meeting. Medscape requires free registration to view.

American Psychiatric Association 2004 Annual Meeting
New Research on Depression, Posters and Abstracts.
Includes short descriptions of the new bipolar disorder research that was discussed during the APA's 2004 annual meeting. Medscape requires free registration to view.

Pediatric Bipolar Conference, Cambridge, MA March 2002 (organized by Joseph Biederman, M.D.)

1. Report on Web site of Harvard University
   

2002 Annual AACAP Convention
Summaries of presentations on early onset bipolar disorder at the annual convention of the American Academy of Child & Adolescent Psychiatry in San Francisco, CA, Oct. 22-27, 2002.

2002 Annual ASAP Convention
Expert presentations on Diagnosis and Treatment of Bipolar Disorder in Children and Adolescents taped at the American Society of Adolescent Psychiatry annual meeting in Chicago, April 21-24, 2002.

Current Issues in the Pharmacotherapy of Pediatric Bipolar Disorder with talks by Drs. Chang, Findling, Scheffer, Kowatch, DelBello, and Wozniak (2 tapes)
Expert presentations taped at the American Academy of Child & Adolescent Psychiatry annual meeting in San Francisco, October 17-23, 2002

Current Research Findings in Pediatric-Onset Bipolar Disorder with talks by Drs. Biederman, Wozniak, Mick, Wilens, Frazier, and Kowatch (2 tapes)
Expert presentations taped at the American Academy of Child & Adolescent Psychiatry annual meeting in San Francisco, October 17-23, 2002.

Research findings presented at the New Clinical Drug Evaluation Unit (NCDEU) 2001 annual meeting

4th International Conference on Bipolar Disorder June 14-16, 2001
(Report by John McManamy).

Assessment Scales and Screening Tools:

Parent Version of the Young Mania Rating Scale (P-YMRS)
by Barbara Gracious, M.D. and colleagues. Used to determine whether a child should be evaluated for possible mania.

Children's Global Assessment Scale (C-GAS)
100-point rating scale measuring psychological, social and schoolfunctioning of children 6-17. Often used on intake and discharge from hospitals.

Mood Disorder Questionnaire for Bipolar Disorder at Depression and BipolarSupport Alliance (DBSA)

Practice Guidelines for Treatment of Bipolar Disorder:

Treatment of Guidelines for Children and Adolescents with Bipolar Disorder (March, 2005).
From the Journal of the Academny of Child & Adolescent Psychiatry. Guidelines based on medical literature, ranking evidence for the treatment of the classic form of the illness (called Bipolar-1) in children ages 6 to 17, and include step-by-step strategies (called algorithms) for treatment of mania and depression, with or without psychosis, in young patients. The guidelines are the result of a consensus conference sponsored by CABF in July, 2003.

Practice Guidelines for the Treatment of Patients with Bipolar Disorder (Revised 2002).
From the American Psychiatric Association. Guidelines based on medical literature, ranking of evidence for each treatment, and review by 7 organizations and over 40 leading researchers and clinicians. To be updated annually. Intended for patients over 18, but with some references to children.

News Releases:

Stress Impairs Thinking Via Mania-Linked Enzyme
Source: National Institute of Mental Health (Oct. 29, 2004)

New Study Examines SEROQUEL Treatment for Depressive Episodes Associated with Bipolar Disorder
Source: Astrazeneca (May 5, 2004)

Parents of bipolar children praise FDA warning on antidepressants, suicidality
Source: Child & Adolescent Bipolar Foundation (March 22, 2004)

FDA Approves Zyprexa(R) for Maintenance of Bipolar Disorder
Source: U.S. Food and Drug Administration (January 15, 2004)

AstraZeneca Receives FDA Approval for SEROQUEL in Bipolar Mania
Source: Astrazeneca (January 13, 2004)

New Study Reveals Two Out of Three College Age Students Do Not Associate Untreated Bipolar Disorder With Risks of Substance Abuse, Suicide, Criminal Behavior (October 8, 2003)

Stanford, Packard Research Finds Better Drug Therapy for Children Predisposed to Bipolar Disorder
Source: Stanford University School of Medicine (August 25, 2003)

New Survey Reveals Common Misperceptions of Bipolar Disorder May Lead to Misdiagnosis in Children
Source: Child & Adolescent Bipolar Foundation (July 28, 2003)

FDA Approves Zyprexa for Use in Combination with Lithium or Valproate to Treat Acute Manic Episodes of Bipolar I Disorder
Source: Eli Lilly and Company (July 15, 2003)

Lamictal: First Medication since Lithium Approved for Long-term Maintenance Treatment of Bipolar Disorder
Source: PR Newswire (June 23, 2003)

New Survey Reveals Stereotypes and Misconceptions Still Shape Americans' Understanding of Bipolar Disorder
Source: PR Newswire (January 28, 2003)

Potential New Treatment for People with Manic Depression
Source: PR Newswire (January 2, 2003)

UHC/CWRU Psychiatry Dept. To Dedicate New Center of Excellence for Bipolar Disorder
Source: University Hospitals of Cleveland and Case Western Reserve University (October 15, 2002)

First Phase III data Confirm Seroquel in Combination with Mood Stabilizer is Significantly More Effective than Mood Stabilizers Alone in Treating Bipolar Mania
Source: AstraZeneca (September 13, 2002)

Bipolar Disorder in Children Appears More Severe Than in Most Adults.
Source: Washington University School of Medicine in St. Louis (June 14, 2001)

CABF Public Testimony:

Concerning Pediatric Suicidality and the Use of Antidepressants: CABF Testimony before the Meeting of the Psychopharmacological Drugs Advisory Committee and the Pediatric Advisory Committee of the Food and Drug Administration
(September 13, 2004)

Pediatric Suicidality & the Use of Antidepressants: CABF Testimony before the FDA’s Pediatric Subcommittee of the Anti-Infective Drugs Advisory Committee and Psychopharmacological Drugs Advisory Committee
(February 2, 2004)

Zoloft review of child safety data by Pediatric Subcommittee of the Anti-Infective Drugs Advisory Committee
Food and Drug Administration (June 12, 2003)

Lithium testing in children lauded by Child & Adolescent Bipolar Foundation
(January 30, 2003)

Peer Reviewed Scientific and Medical Journals (reproduced with permission of publishers):

Axelson, D. et al. A Preliminary Study of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Mania Rating Scale for Children and Adolescents. Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 463-470. A study showing the potential of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode rating scale for measuring manic symptom severity in pediatric bipolar patients.  

Bhangoo, R. et al. Medication Use in Children and Adolescents Treated in the Community for Bipolar Disorder.Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 515-522.An assessment of the use of mood stabilizers, stimulants, antipsychotic medication, and selective serotonin reuptake inhibitors in children being treated in the community for bipolar disorder (BPD).

Biederman, J.,Pediatric Mania: A Developmental Subtype of Bipolar Disorder?2000 (full text).

Biederman, J., et al. An exchange of letters related to the debate about mania and ADHD.Journal of the American Academy of Child & Adolescent Psychiatry, (May 1999) (full text).

Biederman, J., et al. Resolved: Mania Is Mistaken for ADHD in Prepubertal Children.A debate sponsored by the Journal of the American Academy of Child & Adolescent Psychiatry (October 1998).

Bloch, et al. "ECT Therapy in Adolescents: Similarities and Differences from Adults". Child Adolesc. Psychiatry, (2001) (full text). Thisstudy found that Electroconvulsive therapy is effective in adolescents for psychosis associated with bipolardisorder and schizophrenia, with a 58% remission rateachieved in adolescents who had failed to respond to medications alone.J Am Acad Child Adolesc Psychiatry.

Bonifazi, W. Back to school for psychotropics.Nursing Spectrum. December 15, 2003. This article looks at some of the issues surrounding the use of (often off-label and untested) psychotropic drugs for children and adolescents. Copyright 2003. Nursing Spectrum Nurse Wire (http://www.nursingspectrum.com/). All rights reserved. Used with permission.

Carlson, G. Identifying Prepubertal Mania.

Carlson, G. et al. A Comparison of Books on Bipolar Disorder in Children and Adolescents.Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 435-443.

Cecil, K. et al. Proton Magnetic Resonance Spectroscopy of the Frontal Lobe and Cerebellar Vermis in Children with a Mood Disorder and a Familial Risk for Bipolar Disorders.Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 545-555. Similar to findings in adults with bipolar disorders, neurochemical abnormalities within the frontal cortex and the cerebellar vermis were present in this preliminary comparison of children with a mood disorder and a familial risk for bipolar disorder.

Charney, D. and Manji, H. Life stress, genes, and depression: multiple pathways lead to increased risk and new opportunities for intervention.Science's STKE. 2004. .Reprinted with permission from Stephen R. Sprang. (19 September 2000)

Christiana, J.M. et al. Duration between onset and time of obtaining initial treatment among people with anxiety and mood disorders: an international survey of members of mental health patient advocate groups.Psychological Medicine (2000) (full text)
40% of respondents sought treatment in the year of first onset of the disorder. For 60% respondents, the median delay for seeking help was 8 years. The time of initial help-seeking was inversely related to the age of the patient at onset.

Depression and Bipolar Disorder Support Alliance Consensus Statement on the Unmet Needs in Diagnosis and Treatment in Mood Disorders in Children and Adolescents.
Coyle, J. et al. Journal of the American Academy of Child and Adolescent Psychiatry. 2003. Vol. 42(12): 1494-1503.
The findings of the Consensus Development Panel concerning the unmet needs of children and adolescents with bipolar disorder and depression. These findings focus on the lack of specifically trained mental health professionals as well as changes that need to be made in treatments and prevention models.Reprinted with Permission of Lippincott Williams & Wilkins.

DelBello, et al. A Double-Blind, Randomized, Placebo-Controlled Study ofQuetiapine [Seroquel] as Adjunctive Treatment for Adolescent Mania(full text)Seroquel combined with Depakote is found to besignificantly more effective in treating acute mania in adolescents (12-18)than Depakote alone.J. Am. Acad. Child Adolesc. Psychiatry, (2002).

Faedda, Gianni L., MD et al. Pediatric-Onset Bipolar Disorder: A Neglected Clinical and Public Health Problem. Harvard Rev Psychiatry . (1995) (full text)

Faraone, S.V. et al. Attention deficit hyperactivity disorder with bipolar disorder in girls: further evidence for a familial subtype? Journal of Affective Disorders. 2001. Vol. 64(1): 19-27.

Feinberg, D The Real Cost of Pediatric Bipolar Disorder.
Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 431-433.

Findling, Robert L., M.D. et al. Combination Lithium and Divalproex Sodium in Pediatric Bipolarity.J Am Acad Child Adolesc Psychiatry, (2003). An open-label trial indicates that using these two mood stabilizers together as initial treatment may lead to better remission rates than treatment with only one mood stabilizer. (full text)

Geller, Barbara et al. Ages of onset and rates of syndromal and subsyndromal comorbid DSM-IV diagnoses in prepubertal and early adolescent bipolar disorder phenotype. Journal of the American Academy of Child and Adolescent Psychiatry 2003. 42(12): 1486-1493Findings of this study suggest that in a prepubertal group with a bipolar disorder phenotype the onset of attention-deficit/hyperactivity disorder occurs before the onset of mania, while the onset of oppositional defiant/conduct disorder occurs after the first onset of mania. These findings support the development of scales to differentiate preschool ADHD from mania.

Geller, Barbara, MD et al. Double-Blind and Placebo-Controlled Study of Lithium for Adolescent Bipolar Disorders With Secondary Substance DependencyJ Am Acad Child Adolesc Psychiatry. (1998) (full text)Lithium at therapeutic levels for four weeks (after a two week phase-inperiod) was found to significantly improve symptoms of bipolar disorderwhile reducing substance abuse by teens in this landmark study funded by the National Institute of Drug Abuse.

Geller, Barbara, M.D. and Luby, Joan, M.D. Child and Adolescent Bipolar Disorder: A Review of the Past 10 Years.American Academy of Child and Adolescent Psychiatry (1997). (full text)

Geller, B, et al. Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections.
J Am Acad Child Adolesc Psychiatry.

Geller B, et al. "Two-year prospective follow-up of children with a prepubertal and earlyadolescent bipolar disorder phenotype,": Am J Psychiatry 2002 (abstract only). The first two-year naturalisticfollow-up of children with prepubertal and early adolescent mania.Relatively poor outcome was shown with community treatment (not in anacademic research setting) for these very ill children with mixed mania andcontinuous rapid cycling, less than half of whom received any antimanicmedication.

Geller, B. et al. Bipolar disorder at prospective follow-up of adults who had prepubertal major depressive disorder.Am J Psychiatry 2001 Jan;158 (1):125-7 (abstract only).

Geller, Barbara, et al. DSM-IV Mania Symptoms in a Prepubertal and Early Adolescent Bipolar Disorder Phenotype Compared to Attention-Deficit Hyperactive and Normal Controls. in Journal of Child and Adolescent Psychopharmacology, Vol. 12, Number 1, 2002, (abstract only).

Geller, Barbara, et al. Prepubertal and early adolescent bipolarity differentiate from ADHD by manic symptoms, grandiose delusions, ultra-rapid or ultradian cycling.
Reprinted from Journal of Affective Disorders, Volume 51, (1998) (abstract only).

Ghaemi, S. Nassir, et al. Is bipolar disorder still underdiagnosed? Are antidepressants overutilized?Journal of Affective Disorders (1999). (full text)

Gracious, B. et al. Elevated thyrotropin in bipolar youths prescribed both lithium and divalproex sodium.Journal of the American Academy of Child and Adolescent Psychiatry. 2004.43(2): 215-220. Study of the effects of combined lithium and depakote on thyroid stimulating hormone (TSH). The study concluded that lithium is associated with significant rates of TSH elevation in youths with bipolar disorder.

Gracious, Barbara L. et al. Discriminative Validity of a Parent Version of the Young Mania Rating Scale.Journal of the American Academy of Child and Adolescent Psychiatry (2002) (full text).It is likely that the P-YMRS is a statistically effective test for discriminating between bipolar disorder and other Axis I disorders (such as ADHD). It is also a good measure for monitoring response to treatment. However, it is not a diagnostic tool and should be used to help assess whether a child should be screened for a disorder by a professional.

Grof, P. et al. Protective effect of pregnancy in women with lithium-responsive bipolar disorder.Journal of Affective Disorders (2000) (full text).This study suggests that women with bipolar disorder may have fewer episodesof illness while pregnant.

Hellander, M. Medication-induced mania: ethical issues and the need for more research. Journal of Child and Adolescent Psychopharmacology. 2003 Vol. 13(2): 199. The dangers of mania triggered by antidepressants or stimulants in children and adolescents. A call for doctors and parents alike to be informed, and for more research to be done. Reprinted with the permission of Mary Ann Liebert, Inc.

Hellander, M. Depression and Suicidality in Preschoolers
Journal of the American Academy of Child and Adolescent Psychiatry. 2003 Vol. 42(10): 1141A letter to the editor citing evidence of the manifestation of depression and suicidality in young children, and the need for continuing investigation for treatment options.

Henry, C. et al.Long-Term Outcome with Divalproex in Children and Adolescents with Bipolar Disorder.Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 523-529.In children aged 4-18 years, divalproex treatment was related to improved outcome in the long-term treatment of bipolar disorder. One third of the patients discontinued treatment secondary to side effects, including a case of reversible liver enzyme elevation.National Institute of Mental Health Research Roundtable on Prepubertal Bipolar Disorder.

National Institute of Mental Health Research Roundtable on Prepubertal Bipolar Disorder 
A Special Communication published in the Journal of the American Academy of Child & Adolescent Psychiatry, August, 2001 (full text). A roundtable of invited clinicians and researchers with expertise on bipolar disorder in children concluded that diagnosis of bipolar disorder using DSM-IV criteria is possible in prepubertal children.

Kafantaris, V. et al. Lithium treatment of acute mania in adolescents: A large open trial.Journal of the American Academy of Child and Adolescent Psychiatry (2003) (full text). Of 100 subjects, 63 improved and 26 achieved remission of manic symptoms by the fourth week. Prominent depressive features, age at first mood episode, severity of mania, and comorbidity with ADHD did not distinguish those who responded to the medication from those who did not. Lithium appears effective for acute stabilization of symptoms of acutely manic adolescent (ages 12-18).

Kafantaris, Vivian, M.D., Treatment of Bipolar Disorder in Children andAdolescents. Journal of the American Academy of Child andAdolescent Psychiatry (1995) (full text).This article contains a valuable summary of researchstudies on lithium use in children between FDA approvalin 1970 for treatment of adults (and teens over 12) withmania and its publication in 1995.

Kasen, Stephanie PhD, et al., Childhood Depression and Adult Personality Disorder: "Alternative Pathways of Continuity", Archives of General Psychology, 2001 (abstract only).

Kovacs, M. ; Pollock, M. Bipolar disorder and comorbid conduct disorder in childhood and adolescence.Journal of the American Academy of Child & Adolescent Psychiatry June 1995;34(6):715-23 (abstract only).

Kowatch, Robert A. et al. Effect Size of Lithium, Divalproex Sodium, and Carbamazepine in Children and Adolescents With Bipolar Disorder Journal of the American Academy of Child & Adolescent Psychiatry (2000) (full text).

Malone, Richard P. MD, et al. Nonpharmacological Response in Hospitalized Children With Conduct DisorderJ Am Acad Child Adolesc Psychiatry, Volume 36(2).February 1997 (242-247) (abstract only).

Mercer, Jean. Attachment therapy using deliberate restraint: an object lesson on the identification of unvalidated treatments.Journal of Child and Adolescent Psychiatric Nursing (2001) (full text). Unvalidated psychiatric treatments such as attachment therapy, which includes rebirthing therapy, holding therapy, and therapeutic parenting, can be dangerous and potentially lethal to children.

Mick, E. et al. Defining a Developmental Subtype of Bipolar Disorder in a Sample of Nonreferred Adults by Age at Onset. Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 453-462. In contrast with adult-onset bipolar disorder, child-onset bipolar disorder was associated with a longer duration of illness, more irritability than euphoria, a mixed presentation, a more chronic or rapid-cycling course, and increased comorbidity with childhood disruptive behavior disorders and anxiety disorders.Pavuluri, Mani N.; Naylor, Michael; and Janicak, Philip G.

Recognition and Treatment of Pediatric Bipolar Disorder.Contemporary Psychiatry (April 2002) (full text). An excellent summary of pediatric onset and adolescent onset bipolar disorder, and treatment guidelines used by the Pediatric Mood Disorders Clinic at University of Illinois at Chicago.

Preskorn, S and Flockhart, D. 2004 Guide to Psychiatric Drug Interactions. Primary Psychiatry. 2004;11 (2) 39-60. Reprinted with permission of MBL Communications, Inc. Overview of drug-drug interactions, with useful tables showing principle mechanism of action for commonly used psychiatric medications; relative binding affinity for specific neuroreceptors (table 6); major drug-drug interactions (table 14); and chart of substrates, inhibitors and inducers for the major CYP (liver) enzymes used to metabolize drugs (table 15).

Pilcher, Helen R. The ups and downs of LithiumNature: Science Update. September 22, 2003.Lithium has been used for decades to treat manic depression and may help combat other brain disorders, so how come no one knows for sure why it works?Reprinted with Permission of Macmillan Publishers Limited.

Post, Robert, et al. "The Role of Complex Combination Therapy in the Treatment of Refractory Bipolar Illness" (CNS Spectrums, May l998) (abstract only).

Pruett, John R. Jr; Joan L. Luby. January 14, 2004. Recent Advances in Prepubertal Mood Disorders: Phenomenology and Treatment. From Current Opinion in Psychiatry, available on Medscape, requires (free) registration. An excellent overview of advances of the past three years in diagnosis and treatment.

Quackenbush, D. et al. Canadian Journal of Psychiatry. 1996 Vol. 41(1): 16-22. Premorbid and postmorbid school functioning in bipolar adolescents: description and suggested academic interventions. The pre and post illness school functioning of 44 adolescents with adolescent onset bipolar disorder was studied in order to evaluate and describe the changes in school functioning after onset of illness. Assessment measures included a personal interview, review of school history and formal academic testing. The results seem to indicate that good to excellent scholastic functioning before the onset of illness significantly deteriorates after the onset of illness in most adolescents. Marked deterioration appears in work effort, involvement in extracurriculars, academic achievement and peer relationships. Specific program modifications in the school are needed in order to help these adolescents including an open communication between the clinician, parents and the school.Reprinted with the permission of The Canadian Journal of Psychiatry.

Robertson, H. et al. Impact of early onset bipolar disorder on family functioning: Adolescent's perceptions of family dynamics, communication, and problems. Journal of Affective Disorders. 2001. Vol. 66(1): 25-37.This study examined the perceived family functioning in stabilized bipolar I disorder patients and unipolar depression patients, as well as a control group. They found that there were no significant sex or group differences in controls versus mood disordered youths in ratings of relationships with either parent. However, those with bipolar I disorder acknowledged significantly more minor conflicts with parents than either those with unipolar depression or controls.

Ryan, Neal D. et al. Mood Stabilizers in Children and Adolescents.Journal of the American Academy of Child & Adolescent Psychiatry (1999) (full text).

Schurhoff, F. et al. Early and late onset bipolar disorders: two different forms of manic-depressive illness?Journal of Affective Disorders (2000) (full text).Early and late onset bipolar disorders differ in clinical expression and familial risk and can be considered as different subforms of manic-depressive illness.

Shoshana, Y. et al. Employing Parent, Teacher, and Youth Self-Report Checklists in Identifying Pediatric Bipolar Spectrum Disorders: An Examination of Diagnostic Accuracy and Clinical Utility. Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 471-488. The current study examines whether commonly used behavior checklists - the Child Behavior Checklist, Teacher Report Form, and the Youth Self-Report form - are clinically useful in making a differential diagnosis between BPSD and other disorders. Results indicate that the Child Behavior Checklist has limited utility when attempting to derive clinically meaningful information about the presentation of juvenile BPSD.

Siggurdsson, Engilbert, et al. Neurodevelopmental antecedents of early-onset bipolar affective disorderBritish Journal of Psychiatry, 1999, 174, l2l-l27 (abstract only).

Sussman, N. et al. Chronic Marijuana Use and the Treatment of Mentally Ill Patients Primary Psychiatry 2003 Vol. 10(9): 73-76. A review of the harm that marijuana use can have on patients with mental illness. Also the difficulty patients have discontinuing marijuana use, and the ways in which continued use can complicate the treatment efforts.

Tillman, R. et al. Temperament and Character Factors in a Prepubertal and Early Adolescent Bipolar Disorder Phenotype Compared to Attention Deficit Hyperactive and Normal Controls.Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 531-543. This study compares the temperament and character (T/C) factors in a prepubertal and early adolescent bipolar disorder phenotype (PEA-BP), attention deficit hyperactivity disorder (ADHD), and normal community controls (NC). The findings are consistent with studies of novelty seeking in adults who had either BP or ADHD and are discussed in relationship to genetic studies of dopamine receptors and novelty seeking.

Weitzel, Cathy A. Could you spot this psych emergency?RN Magazine (2000) (full text).Neuroleptic Malignant Syndrome is a potentially lethal side effect of antipsychotic medications. Parents need to know the warning signs.

Wilens T., Biederman J., et al. Risk for Substance Abuse Disorders in Youth with Child-and Adolescent-Onset Bipolar Disorder.Journal of the American Academy of Child & Adolescent Psychiatry (1999) (full text). Bipolar disorder is associated with high risk of developing substance abuse, with substantially higher risk in the children whose illness began in adolescence as compared to those with prepubertal onset.

Wilens, Timothy E., Wyatt, Daniel , Spencer, Thomas J. MD. Disentangling Disinhibition.Journal of the American Academy of Child & Adolescent Psychiatry (1998). An excellent discussion of adverse medication reactions such as disinhibition, activation, and unmasking an underlying psychiatric disorder such as anxiety or mania.

Wilens, T. et al. Patterns of Comorbidity and Dysfunction in Clinically Referred Preschool and School-Age Children with Bipolar Disorder.Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 495-505. This study reports on the clinical characteristics, psychiatric comorbidity, and functioning of preschoolers identified with BPD who were referred to a pediatric psychiatric clinic. The results suggest that clinically referred preschoolers with BPD share with school-age children with BPD high rates of comorbid psychopathology and impaired functioning

Wozniak, J. et al. Heterogeneity of childhood conduct disorder: further evidence of a subtype of conduct disorder linked to bipolar disorder.Journal of Affective Disorders (2001).Comorbid bipolar disorder and conduct disorder may be a distinct familial subtype and not due to the chance co-occurance of the two disorders.

Wozniak, Janet M.D. et al. Antecedents and Complications of Trauma in Boys With ADHD: Findings From a Longitudinal Study.Bipolar disorder (mania) in a child is a significant predictor of subsequent trauma. Severe irritability and mood symptoms in a traumatized child may indicate pre-existing mania rather than a reaction to the trauma, and should be treated accordingly.

Wozniak, J. Pediatric Bipolar Disorder: The New Perspective on Severe Mood Dysfunction in Children. Journal of Child and Adolescent Psychopharmacology. 2003. Vol. 13(4): 449-451.An analysis of the changes that have taken place in the last 10 years in the diagnosis of pediatric bipolar disorder.

General Publications:

American Academy of Child & Adolescent Psychiatry, What is a Child and Adolescent Psychiatrist?
Description of training and practice of doctors who practice this specialty.

Arehart-Treichel, Joan, Study Helps Pinpoint Children With Depression.
The major symptoms of depression in very young children are sadness, irritability, and a loss of pleasure in play or other activities, a new study reveals. Psychiatric News (April 4, 2003).

Doskoch, Peter, "Can schizophrenia be prevented?".
Neuropsychiatry News. 2000 Vol. 1(6).With permission of the editor.A discussion of what doctors and scientists are currently working on in order to prevent schizophrenia by identifying it early and treating it.

Fink, Max. Pediatric ECT [Electroconvulsive Therapy]
CME Inc. (1994)

Geller, Barbara M.D., and Rebecca Tillman, M.S. "Hypersexuality in Children With Mania: Differential Diagnosis and Clinical Presentation"
Psychiatric Times October 2004 Vol. XXI Issue 12

Hellander, Martha. Easing the Burden: Childhood Onset Bipolar Disorder and the Internet.
A White Paper comissioned by the National Institute of Mental Health. Hellander is Executive Director of the Child & Adolescent Bipolar Foundation (2000).

Jackson, Linda Watts, With Child M.D.s in Short Supply, Organizations Get Creative.
Behavioral Healthcare Tomorrow (Feb. 2004)

Kluger, Jeffrey, "Young and Bipolar"
Time Magazine cover story featuring CABF families (August 19, 2002)

McManamy, John. McMan’s Depression and Bipolar Web
A collection of articles by John McManamy, a journalist with bipolardisorder who covers research news, medical conferences, and offersthoughtful reflections on living with the illness. A subscription to his excellent newsletter is free.

National Institute of Mental Health, Child and Adolescent Bipolar Disorder: An Update.
(Oct. 30, 2001)

Neuroscience Tutorial
Washington University School of Medicine illustrated guide tothe essential basics of clinical neuroscience

Shear, Katherine. Anxiety and Bipolar Disorder
Stanley Center Innovations for Particpants (Spring and Fall, 1997). http://thalamus.wustl.edu/course/

Torrey, E. Fuller and Michael B. Knable, Scientologists, Antipsychiatrists, and "Consumer Survivors"
An excerpt from Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families and Providers (Basic Books, 2002).

Torrey, E. Fuller M.D., Bird Brains: While 2.3 million Americans suffer from bipolar disorder, theNational Institute of Mental Health is studying how pigeons think.
Washington Monthly (2001).

Torrey, E. Fuller M.D., et al, "A Federal Failure in Psychiatric Research:Continuing NIMH Negligence in Funding Sufficient Research on SeriousMental Illnesses"
(Nov. 19, 2003), on Web site of Treatment AdvocacyCenter.

Treatment Advocacy Center, Cognitive impairments in bipolar disorder and schizophrenia.
Cognitive impairment: a major problem for individuals with schizophrenia and bipolar disorder.

Treatment Advocacy Center, Schizophrenia and Manic Depressive Disorder are Diseases of the Brain.
Briefing Paper summarizing physical findings in brain research on these two illnesses.

Trudeau, Tracey, Educator's Guide to Receiving Bipolar Students After Hospitalization
(1999)

CABF Newsletter Articles:

Geller, Barbara, Hypersexuality in Children With Mania,
November 29, 2001.

Geller, Barbara and Hellander, Martha, Movement Side Effects of Antipsychotics Parkinsonism, Tardive Dyskinesia, and Akathesia,
June 18, 2003.

Geraci, Dorie and Nugent, Clare, Pill Swallowing Tips,
December 7, 2003.

Hellander, Martha, Girls With Bipolar Disorder: Special Concerns
October 7, 2004

Hellander, Martha, Relapse and Grief
July 29, 2004

Hellander, Martha, and Geraci, Dorie, Neuroleptic Malignant Syndrome and Serotonin Syndrome: What Parents Must Know
July 29, 2004

Lynn, George, Counseling Children With Bipolar Disorder: A Psychotherapist's Notes
(2000)

Family Stories:

Anonymous (a physician), A Terrible Wish (2001)

Caruso, K. T., If You Knew Her (Essay, November 2003)

Cheryl, Jerry's Story: Early-onset bipolar - a mother's perspective

DiEmedio, Julie, Our Children of the Ocean (Poem, March 2004)

Goldmark, Rachel, Bipolar Disorder, There Really is Hope! August 2004 (From Folsom Style)

My daughter was trapped in the system by Irene Darmstedter.
"My 26-year-old daughter suffers from bipolar disorder with psychotic tendencies. Her illness began to surface after the sudden death of my 13-year-old son from bacterial meningitis. At the time, my daughter was a straight A student in high school…a wonderful, outgoing person…someone other parents wanted their sons and daughters to be like. But soon after my son's death, she began using drugs and exhibiting bizarre behavior…” (From Web site of the Treatment Advocacy Center).

Nadine, Five-year-old-boy Responds To Two Mood Stabilizers (1999)

Sigrid, Parenting a Bipolar Child -- a Mother's Thoughts, July 1997.

Steel, Danielle, Testimony before Senate Appropriations Committee (February 8, 2000).

Werner, Michael, Emmaline (ll) appears in HBO special on childhood depression.
(December 15, 1999)

News Articles:

Child, Geriatric Psychiatrists Worry About Workforce
Psychiatric News (April 4, 2003)

Senator Paul Wellstone, "A Beautiful Mind affirms need for mental health coverage,"
PioneerPlanet /St. Paul (Minnesota) Sunday, (January 27, 2002)

Arrest My Kid; He Needs Mental Health Care
by Anne-Marie Cusac, (July 2001)

Kids with mental illnesses a challenge for schools By Colleen Pohlig
Seattle Times Eastside bureau, (June 24, 2001)

AFSP Asks, Adolescent Angst ... or Something More Serious?
New Screener Predicts Teens at Risk for Suicide. (March 8, 2000)

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