NOROPSIKIYATRI ARSIVI-ARCHIVES OF NEUROPSYCHIATRY, vol.46, no.1, pp.34-36, 2009 (SCI-Expanded)
In this study, atypical symptomatology and difficulties concerning the differential diagnosis of bipolar disorder (BPD) in children and adolescents before the first episode are discussed through 4 cases aged 5, 13, 14 and 16 years. Although all cases were treated and followed for months/years with diagnoses such as conduct disorder, attention deficit hyperactivity disorder, borderline disorder, dissociation, and psychosis, their diagnoses were considered as BPD after months or years. Misdiagnosis and/or delayed diagnosis of BIRD are common among children and adolescents. Use of stimulant or antidepressant agents provoked manic symptoms, while antipsychotics (risperidone and aripiprazole) and mood stabilizers (valproic acid and lithium) were useful as combined and/or mono therapy for these cases. BPD should be considered in the differential diagnosis in child and adolescent cases with atypical symptomatology and treatment resistance. (Archives of Neuropsychiatry 2009; 46: 34-6)