Mood swings in young people

Size: px
Start display at page:

Download "Mood swings in young people"

Transcription

1 Mood swings in young people Bipolar I & II Disorders are uncommon before puberty; Mood Dysregulation (MD) is very common before puberty Are they the same problem? What are the beginnings of bipolar? What is emotional dysregulation? Should irritability (DMDD) be a separate condition? No competing financial interests [Funding from MRC, Wellcome; royalties from OUP] Acknowledgements to A.Stringaris, B.Birmaher, E. Heptinstall:

2 Bipolar disorder in young people Excessive and impairing mood changes are very common presentations Are they distinct in Course? Features? Causes? Treatment? Episodes of mania 4 days days+ Chronic lability of mood especially irritability Prevalence <0.1% 1%?? 3%? % w ADHD <

3 Cycles and episodes Mood high DAYS Mood low

4 Cycles and episodes Mood high DAYS Mood low Bipolar I = 7 days Bipolar II = 4 days Bipolar S = less (or fewer symptoms)

5 Cycles and episodes Mood high DAYS Mood low

6 Cycles and episodes Mood angry DAYS Mood sad

7 Bipolar disorder in young people Excessive and impairing mood changes are very common presentations Episodes of mania +/- depression Chronic lability of mood especially irritability Comorbidity frequent, especially ADHD. Careful diagnosis is needed.

8 Bipolar Disorder in the Maudsley Clinical Database (ICD10) 3,641 referred cases under the age of diagnosed mania or bipolar 22% <13; 23% prepubertal; similar presentations Best discriminators from age-matched: elevated mood; depression; depersonalisation; hallucinations; disinhibited; poor concentration; recent onset. (correctly classify 95%) Missed cases diagnosed as depression, hyperkinetic, autism or schizophrenia

9 What is the phenomenology of mania in children? Irritability Elated mood Grandiosity Hypersexuality Racing thoughts Insomnia Overtalkative, distractible, increased activity Are these symptoms reliable? specific? discriminating?

10 Cardinal features of mania Symptom Frequency Specificity Impairing Look for Euphoric ( +) - Substance use; medicn; epilepsy Irritable +++ (+) +++ Episodicity; mood context; -provocation Grandiose Fluctuations; inappropriate - arrogance

11 Associated features of mania Symptom Frequency Specificity Impairing Look for Activity ( +) CHANGE of activity Hypersex uality + (+) Abuse Insomnia Change; no daytime fatigue

12 What phenomenology is useful in diagnosing mania in children? Irritability Elated mood Grandiosity Hypersexuality Racing thoughts Insomnia Overtalkative, distractible, increased activity Episodicity

13 High-Risk Offspring: I 207 offspring from 105 families 32% major mood episode 89% first episodes depressive 17 ± 4 years at age of first episode; youngest 12 years Cycle length 31.0 ± 21 months 61% 5-year recurrence Duffy et al (2009) B J Psychiatry

14 High-Risk Offspring: II 388 offspring from 233 BP offspring from 143 control 21% (v 4%) mood disorder (25% ADHD, 26% anxiety, 19% DBD) 9% risk for depression, 12% for BP by age 12 Birmaher et al (2009) Arch Gen Psychiatry

15 High-Risk Offspring III: Review Expert assessment Affective psychopathology Adolescent/adult onset Structured interview Broad spectrum Child onset sometimes Good for early BP course Good for range of outcomes Duffy et al (2011) Early Intervention Psychiat

16 Clinical Implications Important to recognise bipolar disorder in childhood - predicts a poor outcome - delayed treatment worsens prognosis (?) - guide to therapy - caution with antidepressants - caution with stimulants Important not to over-recognise - require episodes of more than 1-2 days - avoid nonspecific use of neuroleptics Differential diagnosis required - consider alternative diagnoses - bipolar disorder may co-exist with other problems

17 Bipolar disorder in young people: II.Chronic mood dysregulation Excessive and impairing mood changes are very common presentations Comorbidity frequent, especially ADHD. Careful diagnosis is needed. Episodes of mania Chronic lability of mood +/- depression especially irritability

18 Emotional regulation Infancy Preschool School age caregivers and comfort repetitive behaviours self-stimulation attention away effortful self-control tantrum consequences covert resentment masking anger rule learning, culture problem-solving gender differentiation

19 Emotion Dysregulation ED: dimensional trait; it encompasses: emotional expressions and experiences that are excessive in relation to social norms. context inappropriate, and developmentally inappropriate e.g. rapid, poorly controlled shifts in emotion (lability) e.g. the anomalous allocation of attention to emotional stimuli e.g. irritability (inappropriate levels of reactivity), unpredictable mood changes, hot temper, temper tantrums, tearfulness, low frustration tolerance 19

20 Disruptive Mood Regulation Disorder Persistent dysphoria Angry outbursts Not validated (SMD included hyperarousal)

21 Irritability Differential Diagnosis ADHD (with emotional lability) Autism spectrum; organic brain syndromes DMDD/ Severe mood dysregulation Conduct/oppositional Adverse environment; PTSD Bipolar disorder

22 DSM 5 Diagnoses of conditions characterised by irritability Begin by establishing whether it comes in distinct episodes, and any affective features Maximum length of episode: > 48 hours Episode includes euphoria/grandiosity? bipolar Mood between episodes is sad/ angry? MDD criteria met? depression DMDD D MDD - major depressive disordermdd = major depressive disorder DMDD disruptive mood dysregulation disorder

23 DSM 5 Diagnoses of conditions characterised by irritability Maximum length of episode: > 48 hours Episode includes euphoria/grandiosity? bipolar Coexistent problems? Mood between episodes is sad/ angry? MDD criteria met? depression DMDD D MDD = major depressive disorder DMDD disruptive mood dysregulation disorder ODD = oppositional-defiant disorder ADHD=attention deficit/hyperactivity disorder PTSD=post-traumatic stress disorder

24 DSM 5 Diagnoses of conditions characterised by irritability Shorter episodes have a different implication advice Maximum length of episode: > 48 hours 6-48 hours <6 hours Inappropriate to context? Yes Coexistent problems? Mood between episodes is sad/ angry? Episode includes euphoria/grandiosity? MDD criteria met? bipolar depression DMDD D MDD = major depressive disorder DMDD disruptive mood dysregulation disorder ODD = oppositional-defiant disorder ADHD=attention deficit/hyperactivity disorder PTSD=post-traumatic stress disorder

25 DSM 5 Diagnoses of conditions characterised by irritability advice Maximum length of episode: > 48 hours 6-48 hours <6 hours ADHD Substance misuse Autism spectrum Organic brain disease ODD Secondary (drug, diet, PTSD, maltreatment) Inappropriate to context? Yes Coexistent problems? Mood between episodes is sad/ angry? Episode includes euphoria/grandiosity? MDD criteria met? DMDD D bipolar depression MDD = major depressive disorder DMDD disruptive mood dysregulation disorder ODD = oppositional-defiant disorder ADHD=attention deficit/hyperactivity disorder PTSD=post-traumatic stress disorder

26 DSM 5 Diagnoses of conditions characterised by irritability advice Maximum length of episode: > 48 hours 6-48 hours <6 hours ADHD Substance misuse Autism spectrum Organic brain disease ODD Secondary (drug, diet, PTSD, maltreatment) Inappropriate to context? Yes Coexistent problems? Mood between episodes is sad/ angry? Intermittent explosive disorder Episode includes euphoria/grandiosity? MDD criteria met? DMDD bipolar depression MDD = major depressive disorder DMDD disruptive mood dysregulation disorder ODD = oppositional-defiant disorder ADHD=attention deficit/hyperactivity disorder PTSD=post-traumatic stress disorder

27 What is bipolar disorder in young people? An important diagnosis in adolescents - sometimes missed in treating adolescence A similar symptomatology to adults - episodes may be short, eg 1-3 days A rare condition in prepubertal children - symptoms need developmental judgement - mood dysregulation a useful concept

Emotional disorders in ADHD

Emotional disorders in ADHD Emotional disorders in ADHD Eric Taylor King s College London, Institute of Psychiatry Stress, anxiety, depression, anger, hypomania, dysregulation No competing financial interests For people with ADHD,

More information

RANZCP 2010 AUCKLAND, NEW ZEALAND

RANZCP 2010 AUCKLAND, NEW ZEALAND RANZCP 2010 AUCKLAND, NEW ZEALAND Dr Veronica Stanganelli et al. RANZCP 2010 1 INTRODUCTION Bipolar disorder within young people has been debated for years. It is still controversial in DSM V (1), whether

More information

BIPOLAR DISORDER AND ADHD IN CHILDREN

BIPOLAR DISORDER AND ADHD IN CHILDREN BIPOLAR DISORDER AND ADHD IN CHILDREN BIPOLAR I DISORDER IS BEING DIAGNOSED WITH INCREASING FREQUENCY (INTENSITY) IN PRE-PUBERTAL CHIDREN WITH THE CAVEAT (WARNING / STIPULATION) THAT CLASSIC MANIC EPISODES

More information

J. Indian Assoc. Child Adolesc. Ment. Health 2012; 8(1):1-5. Editorial

J. Indian Assoc. Child Adolesc. Ment. Health 2012; 8(1):1-5. Editorial 1 J. Indian Assoc. Child Adolesc. Ment. Health 2012; 8(1):1-5 Editorial Controversies in Paediatric Bipolar Disorder Vivek Agarwal 1, Sivakumar T 2 1.Editor JIACAM & Associate Professor, Department of

More information

Chronic irritability in youth that may be misdiagnosed as bipolar disorder. Ellen Leibenluft, M.D.

Chronic irritability in youth that may be misdiagnosed as bipolar disorder. Ellen Leibenluft, M.D. Chronic irritability in youth that may be misdiagnosed as bipolar disorder Ellen Leibenluft, M.D. Chief, Section on Bipolar Spectrum Disorders Emotion and Development Branch National Institute of Mental

More information

9/29/2011 TRENDS IN MENTAL DISORDERS. Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Autism Spectrum Disorders

9/29/2011 TRENDS IN MENTAL DISORDERS. Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Autism Spectrum Disorders Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Jason J. Washburn, Ph.D., ABPP Director, Center for Evidence-Based Practice TRENDS IN MENTAL DISORDERS Autism Spectrum

More information

Trends in Child & Adolescent Mental Health: What to look for and what to do about it.

Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Trends in Child & Adolescent Mental Health: What to look for and what to do about it. Jason J. Washburn, Ph.D., ABPP Director, Center for Evidence-Based Practice TRENDS IN MENTAL DISORDERS 1 Autism Spectrum

More information

Forty-Eighth Annual Teaching Conference Pediatrics for the Practitioner -UT Health Science Center San Antonio School of Medicine June 10-12, 2011

Forty-Eighth Annual Teaching Conference Pediatrics for the Practitioner -UT Health Science Center San Antonio School of Medicine June 10-12, 2011 Adelaide Robb, MD Associate Professor Psychiatry and Pediatrics Source Advisory Board Disclosure Speaker s Bureau Bristol Myers Squibb Yes Yes Yes Epocrates Research Contract Royalties Yes Stock Janssen

More information

Disruptive Mood Dysregulation Disorder

Disruptive Mood Dysregulation Disorder Walden University ScholarWorks School of Counseling Publications College of Social and Behavioral Sciences 2015 Disruptive Mood Dysregulation Disorder Brandy L. Gilea Walden University Rachel M. O Neill

More information

Class Objectives. Depressive Disorders 10/7/2013. Chapter 7. Depressive Disorders. Next Class:

Class Objectives. Depressive Disorders 10/7/2013. Chapter 7. Depressive Disorders. Next Class: Chapter 7 Class Objectives Depressive Disorders - Major Depressive Disorder - Persistent Depressive Disorder - Disruptive Mood Dysregulation Disorder - Premenstrual Dysphoric Disorder (PMDD) Next Class:

More information

5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development

5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development By Pamela Pepper PMH, CNS, BC DSM-5 Growth and Development The idea that diagnosis is based on subjective criteria and that those criteria should fall neatly into a set of categories is not sustainable,

More information

Post Traumatic Stress Disorder (PTSD) versus Bipolar Disorder: Confusion in the face of chaos.

Post Traumatic Stress Disorder (PTSD) versus Bipolar Disorder: Confusion in the face of chaos. Post Traumatic Stress Disorder (PTSD) versus Bipolar Disorder: Confusion in the face of chaos. Randall Ricardi D.O. Child and Adolescent Psychiatry Phoenix Children s Hospital 6-24-17 10:50am Disclosures

More information

Disruptive mood dysregulation disorder (DMDD) a

Disruptive mood dysregulation disorder (DMDD) a Disruptive mood dysregulation disorder: A better understanding Recognizing key differences in DMDD can help distinguish it from similar pediatric disorders Disruptive mood dysregulation disorder (DMDD)

More information

MOOD DISORDERS 101: A primer for recognizing and intervening with children with DMDD JULIE T. STECK, PH.D., HSPP CRG/CHILDREN S RESOURCE GROUP

MOOD DISORDERS 101: A primer for recognizing and intervening with children with DMDD JULIE T. STECK, PH.D., HSPP CRG/CHILDREN S RESOURCE GROUP MOOD DISORDERS 101: A primer for recognizing and intervening with children with DMDD JULIE T. STECK, PH.D., HSPP CRG/CHILDREN S RESOURCE GROUP OBJECTIVES Participants will develop an understanding of Disruptive

More information

Mastering DSM-5: Diagnosing Disorders in Children, Adolescents, and Adults

Mastering DSM-5: Diagnosing Disorders in Children, Adolescents, and Adults Mastering DSM-5: Diagnosing Disorders in Children, Adolescents, and Adults 1. The original DSM was published in: a. 1942 b. 1952 c. 1962 d. 1972 2. The first attempt to gather information about mental

More information

Deficits in Emotional Regulation in ADHD

Deficits in Emotional Regulation in ADHD Deficits in Emotional Regulation in ADHD Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts

More information

An empirically based alternative to DSM-5 s disruptive mood dysregulation disorder. for ICD-11

An empirically based alternative to DSM-5 s disruptive mood dysregulation disorder. for ICD-11 1 In press, World Psychiatry An empirically based alternative to DSM-5 s disruptive mood dysregulation disorder for ICD-11 John E. Lochman 1, Spencer C. Evans 2, Jeffrey D. Burke 3, Michael C. Roberts

More information

ATTENTION DEFICIT HYPERACTIVITY DISORDER COMORBIDITIES 23/02/2011. Oppositional Defiant Disorder

ATTENTION DEFICIT HYPERACTIVITY DISORDER COMORBIDITIES 23/02/2011. Oppositional Defiant Disorder ATTENTION DEFICIT HYPERACTIVITY DISORDER COMORBIDITIES The comorbidity of ADHD with other disorders is between 60% and 80% The most commonly comorbid disorder that occur alongside ADHD are: Oppositional

More information

Pediatric Behavior Problems: ODD and DMDD. Stanley Brewer, DO Pediatrics Assistant Professor (Clinical) Psychiatry Adjunct Instructor

Pediatric Behavior Problems: ODD and DMDD. Stanley Brewer, DO Pediatrics Assistant Professor (Clinical) Psychiatry Adjunct Instructor Pediatric Behavior Problems: ODD and DMDD Stanley Brewer, DO Pediatrics Assistant Professor (Clinical) Psychiatry Adjunct Instructor Acting out: What to call it Externalizing disorders Oppositional Defiant

More information

6/22/2012. Co-morbidity - when two or more conditions occur together. The two conditions may or may not be causally related.

6/22/2012. Co-morbidity - when two or more conditions occur together. The two conditions may or may not be causally related. Autism Spectrum Disorders and Co-existing Mental Health Issues By Dr. Karen Berkman Objective To present an overview of common psychiatric conditions that occur in persons with autism spectrum disorders

More information

What is the DSM. Diagnostic and Statistical Manual of Mental Disorders Purpose

What is the DSM. Diagnostic and Statistical Manual of Mental Disorders Purpose DSM 5 The Basics What is the DSM Diagnostic and Statistical Manual of Mental Disorders Purpose Standardize diagnosis criteria (objectivity) Assist in research Provide common terminology Public health statistics

More information

Key Messages. Around 20% of children and adolescents are estimated to have mental health disorders or problems

Key Messages. Around 20% of children and adolescents are estimated to have mental health disorders or problems Key Messages Around 20% of children and adolescents are estimated to have mental health disorders or problems In a young person presenting with mental health problems, assessment of suicide risk should

More information

4/29/2015. Dr. Carman Gill Wednesday, April 29th

4/29/2015. Dr. Carman Gill Wednesday, April 29th Dr. Carman Gill Wednesday, April 29th 1 Impacted diagnoses Major changes and rationale Special considerations Implications for counselors A sustained condition of prolonged emotional dejection, sadness,

More information

CHILD & ADOLESCENT PSYCHIATRY ALERTS, VOLUME XV, 2013 INDEX

CHILD & ADOLESCENT PSYCHIATRY ALERTS, VOLUME XV, 2013 INDEX A acceptance and commitment therapy Posttraumatic Stress, 69 ADHD Adjunctive Fatty Acids, 5 Adjunctive Guanfacine Pharmacokinetics, 27 Amantadine, 21 Atomoxetine, 23 Cancer Risk, 31 CBT for Comorbid Anxiety,

More information

Index. Note: Page numbers of article titles are in boldface type.

Index. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A Activity level, in preschoolers, 635 636 ADHD. See Attention-deficit/hyperactivity disorder (ADHD). ADOS. See Autism Diagnostic Observational

More information

CASE 5 - Toy & Klamen CASE FILES: Psychiatry

CASE 5 - Toy & Klamen CASE FILES: Psychiatry CASE 5 - Toy & Klamen CASE FILES: Psychiatry A 14-year-old boy is brought to the emergency department after being found in the basement of his home by his parents during the middle of a school day. The

More information

The DSM-5: Juvenile Court Changes from a Mental Health Practitioner s and Defender s Perspective

The DSM-5: Juvenile Court Changes from a Mental Health Practitioner s and Defender s Perspective The DSM-5: Juvenile Court Changes from a Mental Health Practitioner s and Defender s Perspective Presented by: Antoinette Kavanaugh, Ph.D Forensic Clinical Psychologist, IL Mary Ann Scali, JD, MSW National

More information

Childhood Rage: Diagnosis and Treatment Strategies for Severe Mood Dysregulation - Part 2: Diagnosis and Treatment

Childhood Rage: Diagnosis and Treatment Strategies for Severe Mood Dysregulation - Part 2: Diagnosis and Treatment Liberty University DigitalCommons@Liberty University Faculty Publications and Presentations Department for Counselor Education and Family Studies 2013 Childhood Rage: Diagnosis and Treatment Strategies

More information

Deconstructing the DSM-5 By Jason H. King

Deconstructing the DSM-5 By Jason H. King Deconstructing the DSM-5 By Jason H. King Assessment and diagnosis of disruptive mood dysregulation disorder During the past two decades, the prevalence of pediatric bipolar disorder has dramatically increased.

More information

THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (PICS-7) SCORING GUIDELINES

THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (PICS-7) SCORING GUIDELINES THE HOSPITAL FOR SICK CHILDREN DEPARTMENT OF PSYCHIATRY PARENT INTERVIEW FOR CHILD SYMPTOMS (PICS-7) SCORING GUIDELINES Copyright, The Hospital for Sick Children, Toronto, Canada 2016. For licensing inquiries,

More information

Differentiating Unipolar vs Bipolar Depression in Children

Differentiating Unipolar vs Bipolar Depression in Children Differentiating Unipolar vs Bipolar Depression in Children Mai Uchida, M.D. Director, Center for Early Identification and Prevention of Pediatric Depression Massachusetts General Hospital Assistant Professor

More information

9/17/2013 EVOLUTION OF THE DSM. The Future is Now: DSM-5. The American Psychiatric Association is not. Copyright Statement

9/17/2013 EVOLUTION OF THE DSM. The Future is Now: DSM-5. The American Psychiatric Association is not. Copyright Statement The Future is Now: DSM-5 Jason J. Washburn, PhD., ABPP Center for Evidence-Based Practice American Psychiatric Association Copyright Statement DSM and DSM-5 are registered trademarks of the American Psychiatric

More information

Severe Mood Dysregulation in Children and Adolescents Research Findings Support Diagnostic Validity of Pediatric Bipolar Disorder

Severe Mood Dysregulation in Children and Adolescents Research Findings Support Diagnostic Validity of Pediatric Bipolar Disorder Severe Mood Dysregulation in Children and Adolescents Research Findings Support Diagnostic Validity of Pediatric Bipolar Disorder Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric

More information

Emotional Dysregulation in Adult ADHD Esther Sobanski, MD London, 22nd April 2016

Emotional Dysregulation in Adult ADHD Esther Sobanski, MD London, 22nd April 2016 Emotional Dysregulation in Adult ADHD Esther Sobanski, MD London, 22nd April 2016 Department of Psychiatry and Psychotherapy Central Institute of Mental Health Director Prof. Dr. Andreas Meyer-Lindenberg

More information

Child Planning: A Treatment Approach for Children with Oppositional Disorder

Child Planning: A Treatment Approach for Children with Oppositional Disorder COURSES ARTICLE - THERAPYTOOLS.US Child Planning: A Treatment Approach for Children with Oppositional Disorder A Treatment Approach for Children with Oppositional Disorder. Duration: 3 hours Learning Objectives:

More information

NIH Public Access Author Manuscript J Am Acad Child Adolesc Psychiatry. Author manuscript; available in PMC 2015 April 01.

NIH Public Access Author Manuscript J Am Acad Child Adolesc Psychiatry. Author manuscript; available in PMC 2015 April 01. NIH Public Access Author Manuscript Published in final edited form as: J Am Acad Child Adolesc Psychiatry. 2014 April ; 53(4): 408 416. doi:10.1016/j.jaac.2013.12.026. Disruptive Mood Dysregulation Disorder

More information

International Journal of Recent Advances in Multidisciplinary Research Vol. 04, Issue 05, pp , May, 2017 RESEARCH ARTICLE

International Journal of Recent Advances in Multidisciplinary Research Vol. 04, Issue 05, pp , May, 2017 RESEARCH ARTICLE \ sz www.ijramr.com International Journal of Recent Advances in Multidisciplinary Research Vol. 04, Issue 05, pp.2587-2591, May, 2017 RESEARCH ARTICLE AN INVESTIGATION OF PUBLIC PRIMARY SCHOOL TEACHERS

More information

Announcements. The final Aplia gauntlet: Final Exam is May 14, 3:30 pm Still more experiments going up daily! Enhanced Grade-query Tool+

Announcements. The final Aplia gauntlet: Final Exam is May 14, 3:30 pm Still more experiments going up daily! Enhanced Grade-query Tool+ The final Aplia gauntlet: Announcements Chapter 12 Aplia due tonight Chapter 13 Aplia due Wednesday Final Exam is May 14, 3:30 pm Still more experiments going up daily! Enhanced Grade-query Tool+ Now includes

More information

Bipolar Disorder. Other Organic Diagnoses. Assessment/Diagnosis of Bipolar Disorder 2/6/2018 1

Bipolar Disorder. Other Organic Diagnoses. Assessment/Diagnosis of Bipolar Disorder 2/6/2018 1 Bipolar Disorder 2/6/2018 1 Assessment/Diagnosis of Bipolar Disorder Complicated; mimicking other disorders and has comorbidity (presents with other disorders) Half of bipolar children have relatives with

More information

AMPS : A Quick, Effective Approach To The Primary Care Psychiatric Interview

AMPS : A Quick, Effective Approach To The Primary Care Psychiatric Interview AMPS : A Quick, Effective Approach To The Primary Care Psychiatric Interview February 7, 2012 Robert McCarron, D.O. Assosicate Clinical Professor Internal Medicine / Psychiatry / Pain Medicine UC Davis,

More information

Comprehensive Quick Reference Handout on Pediatric Bipolar Disorder By Jessica Tomasula

Comprehensive Quick Reference Handout on Pediatric Bipolar Disorder By Jessica Tomasula Comprehensive Quick Reference Handout on Pediatric Bipolar Disorder By Jessica Tomasula Official Name Bipolar Disorder; also referred to as Manic Depression Definitions (DSM-IV-TR, 2000) Bipolar I Disorder

More information

The New DSM- 5: A Clinical Discussion Through A Developmental Lens. Marit E. Appeldoorn, MSW, LICSW

The New DSM- 5: A Clinical Discussion Through A Developmental Lens. Marit E. Appeldoorn, MSW, LICSW The New DSM- 5: A Clinical Discussion Through A Developmental Lens Marit E. Appeldoorn, MSW, LICSW 612-412- 1159 mappeldoornlicsw@gmail.com Introductions and My (Not- So- Bad) Dilemma What We Already Know

More information

Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder Presenter: Date: Jacqueline Pei, R. Psych., PhD Carmen Rasmussen, PhD May 5, 2009 The FASD Learning

More information

Pediatric Bipolar Disorder and ADHD

Pediatric Bipolar Disorder and ADHD Pediatric Bipolar Disorder and ADHD Janet Wozniak, M.D. Director, Pediatric Bipolar Disorder Research Program Associate Professor Psychiatry Massachusetts General Hospital Harvard Medical School Disclosures

More information

Pediatric Bipolar Disorder: Advances in Diagnosis and Research

Pediatric Bipolar Disorder: Advances in Diagnosis and Research Pediatric Bipolar Disorder: Advances in Diagnosis and Research Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric Bipolar Disorder Research Program Harvard Medical School Massachusetts

More information

Depressive, Bipolar and Related Disorders

Depressive, Bipolar and Related Disorders Depressive, Bipolar and Related Disorders Robert Kelly, MD Assistant Professor of Psychiatry Weill Cornell Medical College White Plains, New York Lecture available at www.robertkelly.us Financial Conflicts

More information

What's New, What's Hot, What's In, What's Out? The DSM-5 and Special Education Law

What's New, What's Hot, What's In, What's Out? The DSM-5 and Special Education Law What's New, What's Hot, What's In, What's Out? The DSM-5 and Special Education Law Attorney Paige L. Tobin, Murphy, Lamere & Murphy Naami S. Turk, Psy.D. 2 DSM-5: Why the changes? Goal: use most evidence-based

More information

Paediatric Bipolar Disorder & Transitions to adult services. Adi Sharma on behalf of ABS

Paediatric Bipolar Disorder & Transitions to adult services. Adi Sharma on behalf of ABS Paediatric Bipolar Disorder & Transitions to adult services Adi Sharma on behalf of ABS Talk Paediatric Bipolar Disorder [PBD]: Why bother DMDD Comorbidity and/or Differential Diagnoses: EUPD, ADHD & ASD

More information

Treatment of Bipolar Disorder in Youth

Treatment of Bipolar Disorder in Youth Treatment of Bipolar Disorder in Youth Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric Bipolar Disorder Research Program Harvard Medical School Massachusetts General Hospital

More information

III. Anxiety Disorders Supplement

III. Anxiety Disorders Supplement K-SADS-PL A. Screen Interview B. Supplements I. Disorders Supplement II. Psychotic Disorders Supplement III. Anxiety Disorders Supplement IV. Disorders Supplement V. Substance Disorders Supplement Advanced

More information

DSM5: How to Understand It and How to Help

DSM5: How to Understand It and How to Help DSM5: How to Understand It and How to Help Introduction: The DSM5 is a foreign language! Three Questions: I. The first was, What the key assumptions made to determine the organization of the DSM5? A. Mental

More information

Attention deficit hyperactivity disorder (ADHD), Conduct disorder biological treatments

Attention deficit hyperactivity disorder (ADHD), Conduct disorder biological treatments Attention deficit hyperactivity disorder (ADHD), Conduct disorder biological treatments Professor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Royal

More information

Welcome. Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders

Welcome. Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders Welcome Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders 800-767-4411 rogershospital.org Major Changes in DSM-5 As it Relates

More information

Running head: DEPRESSIVE DISORDERS 1

Running head: DEPRESSIVE DISORDERS 1 Running head: DEPRESSIVE DISORDERS 1 Depressive Disorders: DSM-5 Name: Institution: DEPRESSIVE DISORDERS 2 Abstract The 2013 update to DSM-5 saw revisions of the psychiatric nomenclature, diagnostic criteria,

More information

Symposium: How to manage children and adolescents with mental health problems (2)

Symposium: How to manage children and adolescents with mental health problems (2) Symposium: How to manage children and adolescents with mental health problems (2) Sue Hawkridge: Behavioural problems Bernice Castle: Struggling academically Lee Theron: Substance abuse Management of behavioural

More information

Increasing rates of depression

Increasing rates of depression Increasing rates of depression Rates of depression have increased 10-20 times compared to 50 years ago. The average age of a person experiencing depression has gone down. Seligman identifies three causes

More information

5 COMMON QUESTIONS WHEN TREATING DEPRESSION

5 COMMON QUESTIONS WHEN TREATING DEPRESSION 5 COMMON QUESTIONS WHEN TREATING DEPRESSION Do Antidepressants Increase the Possibility of Suicide? Will I Accidentally Induce Mania if I Prescribe an SSRI? Are Depression Medications Safe and Effective

More information

MOOD (AFFECTIVE) DISORDERS and ANXIETY DISORDERS

MOOD (AFFECTIVE) DISORDERS and ANXIETY DISORDERS MOOD (AFFECTIVE) DISORDERS and ANXIETY DISORDERS Shelley Klipp AS91 Spring 2010 TIP 42 Pages 226-231 and 369-379 DSM IV-TR APA 2000 Co-Occurring Substance Abuse and Mental Disorders by John Smith Types

More information

4. Definition, clinical diagnosis and diagnostic criteria

4. Definition, clinical diagnosis and diagnostic criteria 4. Definition, clinical diagnosis and diagnostic criteria 4.1. Definition Major depression is a mood disorder consisting of a set of symptoms, which include a predominance of the affective type (pathological

More information

Irritability in children and adolescents: a challenge for DSM-5

Irritability in children and adolescents: a challenge for DSM-5 Eur Child Adolesc Psychiatry (2011) 20:61 66 DOI 10.1007/s00787-010-0150-4 REVIEW Irritability in children and adolescents: a challenge for DSM-5 Argyris Stringaris Received: 6 October 2010 / Accepted:

More information

ADHD Explanation 5: Medications used in ADHD

ADHD Explanation 5: Medications used in ADHD ADHD Explanation 5: Medications The aim of treatment is efficient functioning and achieving goals in life It is most important to find the dose of medications that works best As children grow they may

More information

Presented by Bevan Gibson Southern IL Professional Development Center -Part of the Illinois Community College Board Service Center Network

Presented by Bevan Gibson Southern IL Professional Development Center -Part of the Illinois Community College Board Service Center Network Bipolar Disorder: What It Means to You and Your Classroom Presented by Bevan Gibson Southern IL Professional Development Center -Part of the Illinois Community College Board Service Center Network Introduction

More information

CERTIFICATION EXAMINATION IN CHILD AND ADOLESCENT PSYCHIATRY Content Blueprint (October 26, 2015)

CERTIFICATION EXAMINATION IN CHILD AND ADOLESCENT PSYCHIATRY Content Blueprint (October 26, 2015) CERTIFICATION EXAMINATION IN CHILD AND ADOLESCENT PSYCHIATRY 2016 Content Blueprint (October 26, 2015) Number of questions: 280 1. Development 13 17% 2. Biological and clinical science 13 17% 3. Psychopathology/Classification

More information

DSM Comparison Chart DSM-5 (Revisions in bold)

DSM Comparison Chart DSM-5 (Revisions in bold) 317.0-318.2 DSM Comparison Chart DSM-IV-TR DSM-5 (Revisions in bold) Multi-axial system s Usually First Diagnosed in Infancy, Childhood and Adolescence Single line diagnosis with specifiers Neurodevelopmental

More information

Key Issues in Child Welfare: Behavioral Health (abridged elearning Storyboard)

Key Issues in Child Welfare: Behavioral Health (abridged elearning Storyboard) Key Issues in Child Welfare: Behavioral Health (abridged elearning Storyboard) We ve covered the key issues of substance use disorders and intimate partner violence. Let s talk now about behavioral health.

More information

Emotional lability in adults with ADHD: a core feature

Emotional lability in adults with ADHD: a core feature Emotional lability in adults with ADHD: a core feature Philip Asherson MRCPsych, PhD Professor of Clinical and Molecular Psychiatry & Honorary Consultant Psychiatrist, MRC Social Genetic Developmental

More information

Behavioural Disorders

Behavioural Disorders Behavioural Disorders BEH Hyperkinetic disorder / attention deficit hyperactivity disorder (ADHD) Behavioural disorders is an umbrella term that includes more specific disorders, such as hyperkinetic disorder

More information

HERTFORDSHIRE PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST. Referral Criteria for Specialist Tier 3 CAMHS

HERTFORDSHIRE PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST. Referral Criteria for Specialist Tier 3 CAMHS Referral Criteria for Specialist Tier 3 CAMHS Specialist CAMHS provides mental health support, advice and guidance and treatment for Children and Young People with moderate or severe mental health difficulties,

More information

Substance Abusing Man with Bipolar Disorder & ADHD. Dr. Abdel-Moneim Abdel-Hakam Senior Consultant Psychiatry Department HMC

Substance Abusing Man with Bipolar Disorder & ADHD. Dr. Abdel-Moneim Abdel-Hakam Senior Consultant Psychiatry Department HMC Substance Abusing Man with Bipolar Disorder & ADHD Dr. Abdel-Moneim Abdel-Hakam Senior Consultant Psychiatry Department HMC Introduction Adam is a 25 year old, single, white, man who is referred after

More information

Mood Disorders Workshop Dr Andrew Howie / Dr Tony Fernando Psychological Medicine Faculty of Medical and Health Sciences University of Auckland

Mood Disorders Workshop Dr Andrew Howie / Dr Tony Fernando Psychological Medicine Faculty of Medical and Health Sciences University of Auckland Mood Disorders Workshop 2010 Dr Andrew Howie / Dr Tony Fernando Psychological Medicine Faculty of Medical and Health Sciences University of Auckland Goals To learn about the clinical presentation of mood

More information

Adult ADHD for GPs. Maria Mazfari Associate Nurse Consultant Adult ADHD Tina Profitt Clinical Nurse Specialist Adult ADHD

Adult ADHD for GPs. Maria Mazfari Associate Nurse Consultant Adult ADHD Tina Profitt Clinical Nurse Specialist Adult ADHD Adult ADHD for GPs Maria Mazfari Associate Nurse Consultant Adult ADHD Tina Profitt Clinical Nurse Specialist Adult ADHD I m a Believer.. Are You? What is ADHD? ADHD is a valid clinical condition defined

More information

Assessment of ADHD and Co-Morbidities

Assessment of ADHD and Co-Morbidities Assessment of ADHD and Co-Morbidities Sam Goldstein Ph.D University of Utah www.samgoldstein.com info@samgoldstein.com The Mindset of the Effective Evaluator Evaluate for intervention. Appreciate and stay

More information

Minnesota DC:0-3R Crosswalk to ICD codes

Minnesota DC:0-3R Crosswalk to ICD codes DC 0-3R 0 Post-Traumatic Stress (this diagnosis must be considered first according to the DC:0-3R decision tree) 150 Deprivation/Maltreatment 200 of Affect 2 Prolonged Bereavement/Grief Reaction 220 Anxiety

More information

Differentiating MDD vs. Bipolar Depression In Youth

Differentiating MDD vs. Bipolar Depression In Youth Differentiating MDD vs. Bipolar Depression In Youth Mai Uchida, M.D. Staff Physician Clinical and Research Programs in Pediatric Psychopharmacology Massachusetts General Hospital Disclosures Neither I

More information

EVOLUTION OF THE DSM 8/23/2013. The New DSM-5 : What Administrators Need to Know. American Psychiatric Association Copyright Statement

EVOLUTION OF THE DSM 8/23/2013. The New DSM-5 : What Administrators Need to Know. American Psychiatric Association Copyright Statement The New DSM-5 : What Administrators Need to Know Jason J. Washburn, PhD., ABPP Director, Center for Evidence-Based Practice American Psychiatric Association Copyright Statement DSM and DSM-5 are registered

More information

Practice Parameter for the Assessment and Treatment of Children and Adolescents with Bipolar Disorder,

Practice Parameter for the Assessment and Treatment of Children and Adolescents with Bipolar Disorder, Practice Parameter for the Assessment and Treatment of Children and Adolescents with Bipolar Disorder, Journal of the Academy of Child and Adolescent Psychiatry, 1997 Primary Authors: Jon McClellan MD

More information

It's Cycling, Not Polarity Understanding and Diagnosing the Bipolar Spectrum

It's Cycling, Not Polarity Understanding and Diagnosing the Bipolar Spectrum It's Cycling, Not Polarity Understanding and Diagnosing the Bipolar Spectrum Session 4022: American Psychiatric Nurses Association National Conference, Louisville, KY Andrew Penn, RN, MS, NP, CNS Psychiatric

More information

University of Pittsburgh

University of Pittsburgh 303: Childhood Mental Health Issues AGENDA Day 1 Introduction & Importance of Child/Adolescent Mental Health Issues in Child Welfare Perceptions about Child/Adolescent Mental Health Issues Child/Adolescent

More information

ACBHCS Mental Health Outpatient (includes PES/CSU) Medi-Cal Included Diagnosis List - Alpha by Name

ACBHCS Mental Health Outpatient (includes PES/CSU) Medi-Cal Included Diagnosis List - Alpha by Name Instructions: DHCS publishes the list of diagnoses covered by Medi-Cal in format. The DSM is used because does not provide specific diagnostic criteria. Providers must always use DSM-5 first and whenever

More information

Preschool Bipolar Disorder

Preschool Bipolar Disorder Preschool Bipolar Disorder Joan L. Luby, MD*, MiniTandon, DO, Andy Belden, PhD KEYWORDS Preschool Bipolar Mania Despite significant progress over the last decade in the characterization and validation

More information

4/28/2014. Goals. A glimpse into the world of naming something. Concept of Diagnostic Nomenclature. Concept of Diagnostic Nomenclature

4/28/2014. Goals. A glimpse into the world of naming something. Concept of Diagnostic Nomenclature. Concept of Diagnostic Nomenclature A glimpse into the world of naming something Goals Explore the evolution of the classification of mental disorders and our journey to define mental disorders in individuals with IDD How do we deal with

More information

True/False Quiz questions on the DSM 5

True/False Quiz questions on the DSM 5 True/False Quiz questions on the DSM 5 These questions were designed to guide your learning about changes and important points in the DSM 5. You can get 15 CE credits for only $69 by taking this quiz at

More information

NEW AND REVISED DSM DISORDERS. Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders

NEW AND REVISED DSM DISORDERS. Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders NEW AND REVISED DSM DISORDERS Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders Objectives 1. Identify the rationale for the Disruptive Mood Dysregulation Disorder

More information

Pediatric Bipolar Disorder and ASD

Pediatric Bipolar Disorder and ASD Pediatric Bipolar Disorder and ASD Janet Wozniak, MD Associate Professor of Psychiatry Massachusetts General Hospital Disclosures My spouse/partner and I have the following relevant financial relationship

More information

ADHD in the mainstream: the role of emotional dysregulation and overlap with common mental health disorders

ADHD in the mainstream: the role of emotional dysregulation and overlap with common mental health disorders ADHD in the mainstream: the role of emotional dysregulation and overlap with common mental health disorders Philip Asherson MRCPsych, PhD Professor of Molecular Psychiatry & Honorary Consultant Psychiatrist,

More information

PSYCHOLOGY. Chapter 15 PSYCHOLOGICAL DISORDERS. Chaffey College Summer 2018 Professor Trujillo

PSYCHOLOGY. Chapter 15 PSYCHOLOGICAL DISORDERS. Chaffey College Summer 2018 Professor Trujillo PSYCHOLOGY Chapter 15 PSYCHOLOGICAL DISORDERS Chaffey College Summer 2018 Professor Trujillo 15.1 WHAT ARE PSYCHOLOGICAL DISORDERS? A psychological disorder is a condition characterized by abnormal thoughts,

More information

CHILD AND ADOLESCENT ISSUES BEHAVIORAL HEALTH. SAP K-12 Bridge Training Module for Standard 4 Section 3: Behavioral Health & Observable Behaviors

CHILD AND ADOLESCENT ISSUES BEHAVIORAL HEALTH. SAP K-12 Bridge Training Module for Standard 4 Section 3: Behavioral Health & Observable Behaviors CHILD AND ADOLESCENT BEHAVIORAL HEALTH ISSUES SAP K-12 Bridge Training Module for Standard 4 Section 3: Behavioral Health & Observable Behaviors MODULE 4: SECTION 34: SECTION 3 4.b. Articulate the school

More information

Goal: To recognize and differentiate abnormal reactions involving depressed and manic moods

Goal: To recognize and differentiate abnormal reactions involving depressed and manic moods Goal: To recognize and differentiate abnormal reactions involving depressed and manic moods Moods versus emotions DSM-IV mood disorders are now two separate categories in DSM-5 Depressive disorders Bipolar

More information

Perspective Truth on ADHD & Medications. Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry

Perspective Truth on ADHD & Medications. Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry Perspective Truth on ADHD & Medications Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry Disclosures National Institute of Health ADHD and Aggression Study Co- Investigator

More information

Classification of mood disorders

Classification of mood disorders Classification of mood disorders Congress of Neuropsychiatry and Neuropsychology 2014 Poznań 27 November 2014 Jules Angst Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital,

More information

Adolescent depression

Adolescent depression Diagnostic skills can differentiate 40 VOL. 1, NO. 7 / JULY 2002 teen angst from psychopathology Ann Wagner, PhD Chief, Autism and Pervasive Developmental Disorders Intervention Research Program Benedetto

More information

DSM-5 Depressive Disorders: Diagnostic and Treatment Implications

DSM-5 Depressive Disorders: Diagnostic and Treatment Implications DSM-5 Depressive Disorders: Diagnostic and Treatment Implications Gary G. Gintner, Ph.D., LPC-S Louisiana State University Baton Rouge, LA gintner@lsu.edu Depressive Disorders Highlights: Chronic depressive

More information

Attention Deficit Hyperactivity Disorder State of the Art. Christopher Okiishi, MD

Attention Deficit Hyperactivity Disorder State of the Art. Christopher Okiishi, MD Attention Deficit Hyperactivity Disorder State of the Art Christopher Okiishi, MD What is ADHD? Three subtypes: Inattentive (under diagnosed, esp. in girls) Hyperactive Impulsive Combined Impairments must

More information

Rutgers University Course Syllabus Atypical Child and Adolescent Development Spring 2017

Rutgers University Course Syllabus Atypical Child and Adolescent Development Spring 2017 Rutgers University Course Syllabus Atypical Child and Adolescent Development Spring 2017 Date & Time: Mon and Wedn. 5:00 6:20 pm Location: Tillett bldg. rm 232 Livingston Campus Instructor: Stevie M. McKenna

More information

WORKBOOK ANSWERS CHAPTER 14 MENTAL DISORDERS

WORKBOOK ANSWERS CHAPTER 14 MENTAL DISORDERS WORKBOOK ANSWERS CHAPTER 14 MENTAL DISORDERS 1. POSTTRAUMATIC STRESS DISORDER SHORT ANSWERS 2. ALZHEIMER DISEASE 3. STRESS IS CONSIDERED A CONTRIBUTING FACTOR CAUSING EXACERBATION OF MENTAL DISORDERS.

More information

Goal: To recognize and differentiate abnormal reactions involving depressed and manic moods

Goal: To recognize and differentiate abnormal reactions involving depressed and manic moods Key Dates TH Feb 9 Begin Dimensions-Behavior, Units IIB, 8 through page 147; MW Ch 9 Betty, Elvis TU Feb 14 Unit 8 147-end and Unit 9; MW Ch 8 Jeffrey and Ch 10 Diana TH Feb 16 Unit 10; MW Ch 11 Theodore

More information

Primary Care: Referring to Psychiatry

Primary Care: Referring to Psychiatry Primary Care: Referring to Psychiatry Carol Capitano, PhD, APRN-BC Assistant Professor, Clinical Educator University of New Mexico College of Nursing University of New Mexico Psychiatric Center Objectives

More information

Practitioner Review: The assessment of bipolar disorder in children and adolescents

Practitioner Review: The assessment of bipolar disorder in children and adolescents Journal of Child Psychology and Psychiatry 50:3 (2009), pp 203 215 doi:10.1111/j.1469-7610.2008.01953.x Practitioner Review: The assessment of bipolar disorder in children and adolescents Argelinda Baroni,

More information

The shift in nosology from the Diagnostic PROCEEDINGS FROM CHILDHOOD TO ADOLESCENCE: DIAGNOSIS AND COMORBIDITY ISSUES * Thomas J. Spencer, MD ABSTRACT

The shift in nosology from the Diagnostic PROCEEDINGS FROM CHILDHOOD TO ADOLESCENCE: DIAGNOSIS AND COMORBIDITY ISSUES * Thomas J. Spencer, MD ABSTRACT FROM CHILDHOOD TO ADOLESCENCE: DIAGNOSIS AND COMORBIDITY ISSUES * Thomas J. Spencer, MD ABSTRACT Attention-deficit/hyperactivity disorder (ADHD) tends to manifest differently in adolescents than in children,

More information

Pediatrics Grand Rounds 5 March University of Texas Health Science Center at San Antonio I-1

Pediatrics Grand Rounds 5 March University of Texas Health Science Center at San Antonio I-1 Diagnosis and Treatment of Depression in Children and Adolescents Steven R. Pliszka, M.D. Professor and Vice Chair Chief, Division of Child and Adolescent Psychiatry Department of Psychiatry The Disclosures

More information