Results from a study published in the February 2007 issue of the American Journal of Psychiatry may one day help clinicians detect and treat 2 severe childhood mood disorders more effectively.
Researchers from the National Institute of Mental Health (NIMH) studied 35 children with pediatric bipolar disorder (BD), 21 children with a syndrome known as severe mood dysregulation (SMD), and 26 healthy children. The subjects’ average age was 12 to 13 years old. Researchers used electroencephalograms (EEGs) to measure the brain’s electrical signals while the children performed a mildly frustrating task. EEG results showed that different brain mechanisms were involved when children with BD and those with SMD became frustrated.
NIMH researchers focused on the brain’s reaction to frustration because irritability is a key symptom of both pediatric BD and SMD. Pediatric BD, like adult bipolar disorder, is characterized by alternating depressive and manic states. During manic episodes, the patient may experience unusually high energy and excitability, elated mood, or extreme irritability. Children with severe mood dysregulation also exhibit extreme irritability and hyperactivity, but they fall short of the criteria for manic episodes.
The results of the NIMH study contradict the opinion of researchers who argue that the definition of pediatric BD should include SMD. They also indicate that in the future, clinicians may be able to use EEGs and other biological measurements to help differentiate between bipolar disorder and severe mood dysregulation in children. For now, clinicians must continue to rely solely on symptoms to diagnose mental disorders, which can lead to errors. Often, diagnosis of pediatric BD is made even more difficult when children show symptoms of additional psychiatric disorders.
The correct diagnosis and treatment of pediatric bipolar disorder has become a major cause for concern. More and more children are being diagnosed with BD, and the disorder is often severe in young people. Approximately 1 percent of adolescents have bipolar disorder. Only recently have researchers begun to focus on pediatric BD; the majority of studies on bipolar disorder have used adult subjects. Children with BD are typically treated with mood-stabilizing and antipsychotic drugs. The efficacy of these medications in children is still being studied.
Similarly, severe mood dysregulation is not well understood. It is believed that SMD affects approximately 3 percent of the pre-adolescent and adolescent population. SMD is a relatively new category, and there is not yet sufficient research on the syndrome. Currently, children with SMD often receive the same treatment as children with bipolar disorder. If pediatric BD and SMD are two different disorders, as the NIMH findings strongly suggest, they may require different treatments.
Source: National Institute of Mental Health
NIMH press release can be read in its entirety at: http://www.nimh.nih.gov/press/ped-bipolar-irritability.cfm