Bipolar Disorders are divided into 2 subgroups as I and II.
BIPOLAR I DISORDER
The main feature of Bipolar I Disorder is clinical It is characterized by one or more Manic Episodes or Mixed Episodes in one way or another.
Often individuals also experience one or more Major Depressive Episodes.
BIPOLAR II DISORDER
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The essential feature of Bipolar II Disorder is a clinical condition characterized by one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode.
PREVALENCE
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 following the attack.
RISK FACTORS FOR BPD IN CHILDREN AND ADOLESCENTS
1. Having a family history of BPD (if the mother/father has BPD, the risk in the child increases 3 times),
2. Having a history of disruptive behavior disorders (conduct disorder, attention deficit hyperactivity disorder,…) the risk increases 2-fold,
3.Eating and sleeping problems in infancy,
4.Frequent crying in infancy,
5.Having adaptation difficulties in infancy and childhood,
6.Exaggerated laughing, history of difficulty in self-control,
7.Alcohol and/or substance use that started at an early age,
8.An angry and restless baby or Being a child in childhood,
9.Dysthymia seen in childhood….
In a child with depression;
-family history of BPD,
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-Psychomotor slowing down,
-Temperature fluctuations,
-If there are psychotic features, the risk for manic attack is higher.
PROGRESSION
Early-onset BPD has a chronic course. Rapidly cycling, severe restlessness and aggressive temperament outbursts may be observed. Before adolescence, an atypical picture usually accompanied by short hypomania attacks and behavioral and impulse problems can be observed. Mixed and psychotic attacks are more common in those starting in adolescence than in adulthood.
In children and adolescents with BPD; school failures, social interaction disorders, legal problems, substance abuse, weight gain problems, suicide attempts The risk is higher. BPD usually begins in childhood and adolescence; >
-Prospective episodes of depression and mania are seen more seriously.
-Periods of remission are rare.
COmorbidity
Childhood and adolescence BPD is most often seen together with ADHD, conduct disorder, and oppositional defiant disorder.
BASIC DIAGNOSTIC CRITERIA FOR MANIC EPISODE
A. A discrete abnormal and strongly elevated, unrestrained, or irritable mood lasting at least 1 week.
B. Three (or more) of the following symptoms during the mood disturbance: continues (only 4 if mood is irritable) and is present to a significant degree:
1.Increased self-love or grandiosity.
2.Decreased need for sleep.
>3.More talkative than usual or pressure to continue talking.
4.Subjective experience of flight of ideas or increased racing of thoughts.
5.Distraction.
>6.Increased goal-oriented activities (socially, at work, at school, or sexually) or psychomotor agitation.
7.Excessive involvement in pleasurable activities with a high potential for painful consequences..
BASIC DIAGNOSTIC CRITERIA FOR DEPRESSIVE EPISODE
3. Significant weight loss or weight gain when not on a diet (sometimes it can be seen as the absence of the expected weight gain in children).
4. Insomnia or excessive sleepiness almost every day.
5. Psychomotor agitation or retardation almost every day.
6. Almost every day day, fatigue-exhaustion or loss of energy.
7. Almost every day, worthlessness, love Blank or inappropriate feelings of guilt.
8. Decreased ability to think or concentrate on a particular subject, or indecisiveness, almost every day.
9. Recurrent thoughts of death. , suicide attempt or a specific plan to commit suicide.
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