Goldstein, Benjamin and Birmaher, Boris and Carlson, Gabrielle and DelBello, Melissa and Findling, Robert and Fristad, Mary and Kowatch, Robert and Miklowitz, David and Nery, Fabiano and Perez Algorta, Guillermo Daniel and Van Meter, Anna and Zeni, Cristian and Correll, Christoph and Kim, Hyo-Won and Wozniak, Janet and Chang, Kiki and Hillegers, Manon and Youngstrom, Eric A. (2017) The International Society for Bipolar Disorders Task Force Report on Pediatric Bipolar Disorder : Knowledge to Date and Directions for Future Research. Bipolar Disorders, 19 (7). pp. 524-543. ISSN 1398-5647
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Abstract
Objectives: Over the past two decades there has been tremendous growth in research regarding bipolar disorder (BD) among children and adolescents (i.e., pediatric BD; PBD). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. Methods: An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps. Results: Substantial, and increasingly international, research has accumulated regarding the phenomenology, differential diagnosis, course, treatment, and neurobiology of PBD. Prior division around the role of irritability and of screening tools in diagnosis has largely abated. Goldstandard pharmacological trials inform treatment of manic/mixed episodes, whereas fewer data address bipolar depression and maintenance/continuation treatment. Adjunctive psychosocial treatment provides a forum for psychoeducation and targets primarily depressive symptoms. Numerous neurocognitive and neuroimaging studies, and increasing peripheral biomarker studies, largely converge with prior findings from adults with BD. Conclusions: As data have accumulated and controversy has dissipated, the field has moved past existential questions about PBD toward defining and pursuing pressing clinical and scientific priorities that remain. The overall body of evidence supports the position that perceptions about marked international (U.S. versus elsewhere) and developmental (pediatric vs. adult) differences have been overstated, although additional research on these topics is warranted. Traction toward improved outcomes will be supported by continued emphasis on pathophysiology and novel therapeutics.