Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder

Robert L. Findling, Barbara L. Gracious, Nora K. McNamara, Eric A. Youngstrom, Christine A. Demeter, Lisa A. Branicky, Joseph R. Calabrese

Research output: Contribution to journalArticlepeer-review

284 Scopus citations


Objectives: The primary purpose of this study was to describe the clinical presentation of bipolar I disorder (BP-I) as it occurs in children and adolescents and to assess whether the manifestations of BP-I were similar in both age groups. Method: Ninety youths between the ages of 5 and 17 years meeting full diagnostic symptom criteria for BP-I were included in this study. The diagnosis of BP-I was established for these youths based on the results of a semi-structured diagnostic interview and a clinical assessment by a child and adolescent psychiatrist. The course of a subset of these youngsters' illnesses was assessed using the Life Charting Method (LCM). Data regarding the clinical presentation, longitudinal history, psychiatric co-morbidities and parental psychopathology were also obtained. Results: The clinical presentation of BP-I was similar in children and adolescents. Youths meeting diagnostic criteria for BP-I developed an average of approximately 5.8 of the 7 symptoms of mania during periods of elevated or irritable mood. BP-I was found to be a cyclic disorder characterized by high rates of rapid cycling (50%) with almost no inter-episode recovery. Almost 75% of these subjects also met diagnostic symptom criteria for a disruptive behavior disorder. High rates of mood disorders were found in fathers. Conclusions: These data suggest that the presentation of juvenile BP-I is a cyclic and valid clinical condition with manifestations on a continuum with the later-onset forms of this illness.

Original languageEnglish (US)
Pages (from-to)202-210
Number of pages9
JournalBipolar Disorders
Issue number4
StatePublished - 2001
Externally publishedYes


  • Adolescents
  • Bipolar disorder
  • Children
  • Family history
  • Life charting

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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