Bipolar Disorders are divided into 2 subgroups as I and II.
BIPOLAR I DISORDER
Bipolar I Disorder is the main feature clinically characterized by one or more Manic Episodes or Mixed Episodes.
Often individuals experience one or more Major Depressive Episodes.
BIPOLAR II DISORDER
The core feature of Bipolar II Disorder is a clinical condition characterized by one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode.
PREVENTION
BPD is rare in children and adolescents. The onset of symptoms often occurs between the ages of 15-19. Its prevalence is 1% in the 14-18 age group. 20-40% of adolescents with major depressive disorder experience only a manic or manic-depressive mixed episode within 5 years of the attack.
RISK FACTORS FOR BPD IN CHILDREN AND ADOLESCENTS
1. Having a family history of BPD (the risk increases 3 times if a parent has BPD),
2. Disruptive behavior disorders If there is a history of (behavioral disorder, attention deficit hyperactivity disorder,…) the risk increases by 2 times,
3. Eating and sleep problems in infancy,
4. Frequent crying in infancy,
5. Difficulty in adjustment in infants and childhood,
6. History of exaggerated laughing, difficulty in self-control,
7. Alcohol and/or substance use at an early age,
8. Being an angry and restless baby or child,
9. Dysthymia in childhood….
In a child with depression;
-Family history of BPD,
-Psycomotor slowdown,
-Temperament fluctuations,
-If there are psychotic features, the risk for manic episode is higher.
DETAILS
Early-onset BPD has a chronic course. Quick-cycling, severe restlessness, and aggressive temper outbursts can be seen. Before adolescence, an atypical picture with short episodes of hypomania, behavior and impulse problems can be seen. Mixed and psychotic episodes are more common in adolescents than in adults.
in children and adolescents with BPD; school failures, social relationship disorder, legal problems, substance abuse, problems with weight gain, suicide attempt risk is higher. BPD that starts in childhood and adolescence is usually;
-Attacks are more frequent.
-Fast cycle process is more common.
-The accompanying disorders are more common.
-Fresh depression and mania attacks are seen more serious.
– Periods of well-being are rare.
Comorbidity
Childhood and adolescence BPD is most commonly seen together with ADHD, conduct disorder, oppositional defiant disorder.
BASIC DIAGNOSTIC CRITERIA for MANIC EPISOD
A. A discrete abnormal and strongly elevated, unrestrained or irritable mood lasting at least 1 week.
B. During mood disturbance, three (or more) of the following symptoms persist (only 4 if mood is irritable) and are present to a significant degree:
1.Self-love or grandiosity swelling of vision.
2. Decreased need for sleep.
3. More talkative than usual or pressure to keep talking.
4.Subjective experience of flying ideas or racing thoughts.
5. Distraction.
6. Increase in goal-directed activities (socially, at work, school, or sexually) or psychomotor agitation.
7. Excessive participation in pleasurable activities with the potential to have painful consequences.
BASIC DIAGNOSTIC CRITERIA for DEPRESSIVE EPISOD
A. 5 or more of the following criteria for at least 2 weeks (Diagnostic criteria 1 or 2)
1. Depressed mood almost every day, all day long (children and adolescents may have irritable mood).
2. Significant decrease in interest or pleasure in all or most activities that persists nearly every day.
3. Significant weight loss or weight gain when not on a diet (sometimes seen as a lack of expected weight gain in children).
4. Insomnia or excessive sleepiness, almost every day.
5. Psychomotor agitation or retardation almost every day.
6. Fatigue-fatigue or loss of energy almost every day.
7. Feelings of worthlessness, excessive or inappropriate guilt nearly every day.
8. Decreased ability to think or concentrate on a particular topic, or indecisiveness, almost every day.
9. Recurrent thoughts of death, suicide attempt, or a specific plan to commit suicide.
