Comparison of manic symptoms across age groups suggested that irritability is a key feature of BD with an onset in childhood , activity is the most prominent in adolescent-onset BD and pressure of speech is more characteristic of adult-onset BD .
Conclusions Despite frequent discussion of similarities and differences in phenomenology of mania presenting in different age groups , systematic research is lacking and studies are still required to reliably establish whether the frequency and severity of manic symptoms varies .
Background In the last two decades , there has been a significant increase in the diagnosis of Bipolar Disorder ( BD ) in children .
The notion of prepubertal onsets of BD is not without controversy , with research ers debating whether paediatric cases have a distinct symptom profile or follow a different illness trajectory from other forms of BD .
The latter issue is difficult to address without long-term prospect i ve follow-up studies .
However , in the interim , it is useful to consider the phenomenology observed in groups of cases with different ages of onset and particularly to compare manic symptoms in children diagnosed with BD compared to cases presenting with BD in adolescence and adulthood .
This review systematic ally explores the phenomenology of manic or hypomanic episodes in groups defined by age at onset of BD ( children , adolescents and adults ; or combined age groups e.g. children and adolescents versus adults ) .
Diagnostic characteristics of child bipolar I disorder: does the "Treatment of Early Age Mania (team)" sample generalize?
OBJECTIVE To examine the representativeness of a r and omized controlled trial ( RCT ) sample versus one obtained by consecutive new case ascertainment , for subjects with child bipolar I disorder . METHOD Subjects ( N = 247 ) were out patients who participated in either the National Institute of Mental Health-funded Phenomenology and Course of Pediatric Bipolar Disorders study or the Treatment of Early Age Mania ( TEAM ) study . Both studies required that subjects have current DSM-IV bipolar I disorder ( manic or mixed phase ) and a Children 's Global Assessment Scale ( CGAS ) score < or=60 . All subjects had elation and /or gr and iosity . Subjects in the Phenomenology study were obtained from 1995 to 1998 by consecutive new case ascertainment from design ated pediatric and psychiatric facilities . Subjects in the  TEAM RCT were recruited from media and community sources between March 2003 and March 2005 . Assessment instruments included the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia , given separately to parents about their children and to children about themselves , and the CGAS . Logistic regression was used for comparisons . RESULTS The TEAM and Phenomenology groups were similar in age ( 10.4 [ SD = 2.3 ] , 10.9 [ SD = 2.3 ] years , respectively ) and other demography . Both had long current episode duration ( 4.8 [ SD = 2.4 ] , 3.2 [ SD = 2.3 ] years ) and low lifetime use of any mood stabilizer ( 23.6 % , 35.0 % ) . Many mania symptoms and ultradian rapid cycling , psychosis , and suicidality were significantly more prevalent in the RCT sample . CONCLUSIONS Generalization of the RCT sample was supported , because only 7.8 % of Phenomenology subjects did not fit the RCT criteria . Nevertheless , because the RCT subjects were more severely ill , it is unclear if treatment findings from the RCT will be applicable to children with less severe mania . CLINICAL TRIALS REGISTRATION Clinical Trials.gov identifier NCT00057681 ( TEAM study )
Comparison of manic symptoms across age groups suggested that irritability is a key feature of BD with an onset in childhood , activity is the most prominent in adolescent-onset BD and pressure of speech is more characteristic of adult-onset BD .
Conclusions Despite frequent discussion of similarities and differences in phenomenology of mania presenting in different age groups , systematic research is lacking and studies are still required to reliably establish whether the frequency and severity of manic symptoms varies .
Background In the last two decades , there has been a significant increase in the diagnosis of Bipolar Disorder ( BD ) in children .
The notion of prepubertal onsets of BD is not without controversy , with research ers debating whether paediatric cases have a distinct symptom profile or follow a different illness trajectory from other forms of BD .
The latter issue is difficult to address without long-term prospect i ve follow-up studies .
However , in the interim , it is useful to consider the phenomenology observed in groups of cases with different ages of onset and particularly to compare manic symptoms in children diagnosed with BD compared to cases presenting with BD in adolescence and adulthood .
This review systematic ally explores the phenomenology of manic or hypomanic episodes in groups defined by age at onset of BD ( children , adolescents and adults ; or combined age groups e.g. children and adolescents versus adults ) .