Depressive episodes in children and adolescents with bipolar disorders

Despite the severe morbidity and mortality associated with bipolar depression, there has been very little research on this phase of bipolar disorders in adolescents or children. Pediatric bipolar disorders often present with a depressed or mixed state that may be initially diagnosed as a major depressive disorder. The treatment of a pediatric bipolar depressive episode is complicated due to the often necessary use of combinations of medication and the potential for inducing mania, hypomania or rapid cycling particularly with antidepressant agents. There are no published prospective controlled treatment studies of bipolar children or adolescents with depression and this research is much needed. In this article, we review what is known about the clinical characterisitcs and treatment of bipolar depression in children and adolescents. (C) 2002 Elsevier Science B.V. All rights reserved.