Prepubertal Bipolar I Disorder and Bipolar Disorder NOS Are Separable From a Time of Uncertainty

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As reported in the recent National Institute of Mental Health (NIMH) Research Roundtable on Pre-pubertal Bipolar Disorder,1 considerable controversy surrounds the definition and prevalence of prepubertal-onset bipolar disorders. Contentious areas included disagreements about diagnostic criteria and differences between presentations of prepubertal bipolar disorder and typical adult-onset mania (i.e., discrete episodes of mania and depression with intervening well periods). Despite these and other ongoing disagreements in the literature, there are data to support an increasing prevalence and younger age at onset of bipolar illness.2–4

J Clin Psychiatry 2004;65(7):898-902