RESULTS There is sufficient evidence for a Grade A recommendation of the use of olanzapine plus fluoxetine at reducing depressive symptoms in bipolar depression and of quetiapine at high doses for depressive symptoms occurring during mixed episodes .
These results mostly overlap with the approved treatments for bipolar depression in adults
BACKGROUND The management of depressive and mixed symptoms in children and adolescents with bipolar disorder ( BD ) remains a matter of debate .
The goal of this review is , thus , to systematic ally examine the impact of atypical antipsychotics ( AAPs ) and mood stabilisers in the treatment of bipolar depression and /or mixed states .
A revised anchored version of the BPRS-C for childhood psychiatric disorders.
The Brief  Psychiatric Rating Scale  for Children ( BPRS-C ) is increasingly used as an outcome measure in research , managed care , and public sector child/adolescent clinical setting s. The BPRS-C was developed to provide a descriptive profile of symptoms applicable to a broad range of child and adolescent psychiatric disorders . Its use frequently includes trained and untrained clinician raters with differing degrees of experience and training in child and adolescent disorders . Unfortunately , this latter approach leads to a large amount of variability in scores and consequently reduces its overall reliability . This study reports on a revised BPRS-C with the addition of clinical descriptive anchors design ed to improve reliability and validity for both trained and untrained raters . A sample of 4,733 children and adolescents seen in 10 public sector facilities was administered the BPRS-C along with other st and ard clinical measures ( Child Behavior Checklist and Global Assessment of Functioning ) . Additional reliability data were gathered in a University Medical Center child and adolescent research site with both trained and untrained raters . The data indicated improvement in overall reliability and validity scores , good internal consistency , and improved factor scores . The addition of an overall total severity score may prove to be a useful outcome measure for assessment of treatment response
RESULTS There is sufficient evidence for a Grade A recommendation of the use of olanzapine plus fluoxetine at reducing depressive symptoms in bipolar depression and of quetiapine at high doses for depressive symptoms occurring during mixed episodes .
These results mostly overlap with the approved treatments for bipolar depression in adults
BACKGROUND The management of depressive and mixed symptoms in children and adolescents with bipolar disorder ( BD ) remains a matter of debate .
The goal of this review is , thus , to systematic ally examine the impact of atypical antipsychotics ( AAPs ) and mood stabilisers in the treatment of bipolar depression and /or mixed states .