This patient’s symptoms may be explained by a primary mood disorder, such as major depressive disorder or bipolar disorder. The presence of both manic and depressive symptoms is suggestive of pediatric bipolar disorder. The patient has many features that are common in patients with pediatric bipolar disorder,1 including coexisting manic and depressive symptoms, predominantly irritable mood without euphoria, and rapid mood fluctuations. When the symptoms of a mood disorder are severe, they may be accompanied by psychotic symptoms, such as the delusional thinking and hallucinations seen in this patient. However, before a diagnosis of primary mood disorder can be made, organic causes of the symptoms must be ruled out.
This patient’s symptoms may be explained by a primary mood disorder, such as major depressive disorder or bipolar disorder. The presence of both manic and depressive symptoms is suggestive of pediatric bipolar disorder. The patient has many features that are common in patients with pediatric bipolar disorder,1 including coexisting manic and depressive symptoms, predominantly irritable mood without euphoria, and rapid mood fluctuations. When the symptoms of a mood disorder are severe, they may be accompanied by psychotic symptoms, such as the delusional thinking and hallucinations seen in this patient. However, before a diagnosis of primary mood disorder can be made, organic causes of the symptoms must be ruled out.
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