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Childhood bipolar disorder is met with skepticism on its validity. Discuss reasons for this skepticism and how you would incorporate this in providing education to parents/caregivers and patients faced with this diagnosis.
Bipolar disorder diagnoses in children can be very complicated and controversial in the psychiatric community. There are a multitude of reasons for this including teasing out other comorbidities such as disruptive behavioral disorder, attention deficit hyperactivity disorder and anxiety (Cichon et al., 2021). There exists a significant lack of evidence for the diagnosis and treatment of child and adolescent bipolar disorder due to the lack of research performed within the pediatric population (Post et al., 2021). This is unfortunate because early interventions and treatment can have a significant positive impact on future outcomes for children that last into adulthood (Cichon et al., 2020). As a PMHNP, I would take a significant amount of time explaining the manic, hypomanic and depressive episodes that define bipolar disorders. Specifically, I would share that irritability remains one of the key prevailing symptoms of bipolar disorder in children (Post et al., 2021). Families should also understand the strong genetic connection and predisposition for bipolar if there is a family history of mood disorders or substance abuse (Post et al., 2021). Psychoeducation should include the DSM V criteria used to guide a diagnosis referencing the manic, hypomanic and depressive features associated with the disorder (APA, 2013). Evidence based research should be referenced that details the efficacy of psychopharmacology and the first line medications recommended for children including atypical antipsychotics like aripiprazole and the efficacy of lithium for bipolar maintenance and the side effects of these medications (Post et al., 2021). Post et al. (2021) shares that psychotherapy interventions that are best suited for bipolar treatment include individual and family focused therapy (FFT). Providers must work closely with both the child and the family to coordinate treatment efforts and to support the patient through their journey with bipolar.
Discuss reasons for this skepticism and how you would incorporate this in providing education to parents/caregivers and patients faced with this diagnosis.
Published by Jeannie R. Ferrell
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