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Running head: Why is it so difficult to diagnose bipolar disorder in children? 1

AN OVERVIEW: OF DIAGNOSING BIPOLAR DISORDER IN CHILDREN 4

Why is it so difficult to diagnose bipolar disorder in children?

By:Lakendra Green

An Overview of the Research Topic

This research begins with an introduction of the topic of my research. Firstly, I will describe a summary of our main topic question that is “Why is it so difficult to diagnose bipolar disorder in children? Later, the study background, research objective, problem statement and I will review in this section. Moreover, the support, range of the research, and limitation of the subject support fully described in study one.

Introduction: In the past few years, there has been a meaningful improvement in the diagnosis of Bipolar Disorder in children, the nominal pediatric or childish -onset form of Bipolar Disorder (Moreno et al. 2007). The idea of prepubertal origins of Bipolar Disorder is not completely affirmed, with researchers discussing whether the state lives in the age group (or if misdiagnosis of another childhood ailments like Attention Deficit Hyperactivity Disorder) also, if it survives, how simple it is, etc. Whilst clinicians and researchers do not dispute that children diagnosed with pediatric Bipolar Disorder have mental dilemmas that require attention and medicine, there is never consensus about whether this childhood disease is the equivalent disease as ‘adult- original’ Bipolar Disorder that typically performs from children onwards. One problem that has maintained this discussion is the absence of consensus on the essence signs of mania or hypomania (that we relate to as hypomania) manifesting in children. For instance, many researchers recommend that the childish kind of Bipolar Disorder is more suitable to perform with anger somewhat than happiness in desire, that combined cases may also be simple, or that there are variations in the number of hardness of Bipolar Disorder symptoms recognized in children related to different age groups.

This is a significant approach; however, several of the statements rely on descriptions of the number of distinct hypomanic signs in specimens composed of children alone, sooner than studying subjects that immediately connect the signs of hypomanic experiences crossed this age group. Moreover, the pieces of knowledge of phenomenology frequently utilize various paths to including the signs. For instance, few investigations describe the appearance or lack of the symptoms recorded in universally accepted on distinguishing models (like the A and B models published in the Symptomatic and Statistical Manual (DSM IV)). In opposition, different investigations utilize sign grade systems (like the "Young Mania Rating Scale" (YMRS); (Young et al. 1978) that evaluate the hardness of all signs that are today (and describe the low hardness number for every part toward the rating scale). Finally, I will do a few investigations of children utilize data collected from parent's interviews or from a teacher. Investigations of children and grown-ups regularly essentially rely on data collected from conversations with the average position (the body with Bipolar Disorder).

Background: Ultimately, I will explain the consequence time that I frequently utilize in the research. Bipolar Disorder is a critical psychic disease that includes variations in attitude, thought, and behavior. It can be classified in three large subgroups: Bipolar Disorder -I (identified by experiences of depression and mania); Bipolar Disorder-II (depression and hypomania) and a diversified group that is seldom applied to as spectrum diseases, which involves Bipolar Disorder-NOS, cyclothymia, and another smaller clear Bipolar Disorder-like symptoms (Akiskal et al. 2000). The global ubiquity of each display of is approximately 4 % (Angst 1988). The top age of encounter is 15 to 25 years, although the rate continues very high, completely early, and mid- grown living (Merikangas et al. 2011). It is recommended that problems with children or typically started with related sign forms for every stage of the Bipolar Disorder disorder, e.g., depressive, hypomanic, manic, and mixed experiences (where manic and depressive symptoms co-occur), and that the number of various kinds of experiences is also similar (e.g., depressive experiences are frequent; combined events are comparatively limited) (Angst 1988). There have been few changes described in those things by the age of encounter, although overall problems manifesting in childhood are normally seen as becoming ‘adult- original’ Bipolar Disorder with different experiences.

Research Purpose: The main purpose of my study will investigate exactly whether the clinical phenomenology about hypomania changes over two age groups (children and adolescents) (e.g., a united collection of children and teenagers connected to grown-ups with Bipolar Disorder ). The particular research questions are given below:

1. Is there a variation in the various commonly described signs of hypomania in varying age group in similar investigations that utilize accepted diagnostic models, e.g., ICD or DSM (World Health Organization 1992), or that apply measures that regulate the heart signs of Bipolar Disorder, e.g., Kiddie- Program for Affective Diseases and Schizophrenia?

2. Is there a distinction in the signs of hypomania that are considered as the common critical in various age groups in related investigations that utilized to set rating scales of symptom, e.g., the YMRS?

Methods: To solve the important research questions, I will identify papers that performed a personal identification of the signs of hypomania in people with adolescence, children, and /or adults- start Bipolar Disorder.

Search Strategy: Established research of a couple of online databases was initiated to recognize any possibly related peer- studied unique reports, summaries, or discussion courses. Reference files of papers were also examined for further papers. The period of the past research will be restricted from the year 1980 to 2016. The origin date was adopted because that was the initial time the Bipolar Disorder diagnosis was covered through the DSM categorization method. The research applied sequences of words from three general classes: group one uses many terms for Bipolar Disorder (e.g., manic depression); group two involved words for age groups (e.g., children); and group three concentrated on words uses to express symptoms of hypomanic or manic (e.g., psychopathology).

Conclusion: The information on symptom patterns (practicing a composite ranking of number and sharpness) described as weighted rates over age groups. As noted, there are few differences in sign models through age, including annoyance /aggressiveness being the several notable features of Bipolar Disorder in children, and action /energy is the common noticeable in childhood Bipolar Disorder; the other common obvious sign is both certain age groups is happy/euphoric feeling. In Bipolar Disorder in the grown-up, the two common noticeable signs are these connected with differences in perception (particularly speed of reasoning as defined by the strength of communication and contending ideas; and content of reasoning as defined by grand or unusual approaches).

Sources for the Research

Akiskal HS, Bourgeois ML, Angst J, Post R, Hans-Jürgen M, Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord. 2000;59:S5–S30.

Angst J. The emerging epidemiology of hypomania and bipolar II disorder. J Affect Disord. 1988;50(2–3):143–151. 

Merikangas KR, Jin R, He JP, Kessler RC, Lee S, Sampson NA, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68(3):241–251.

Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry. 2007;64(9):1032–1039.

World Health Organization . The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992. 

Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133(5):429–435.