Background: Thediagnosticstabilityofpediatricbipolardisorderhasnotbeeninvestigatedpreviously.The
aimwastoinvestigatethediagnosticstabilityoftheICD-10diagnosisofpediatricmania/bipolardisorder.
Methods: Allpatientsbelow19yearsofagewhogotadiagnosisofmania/bipolardisorderatleastonceina
periodfrom1994to2012atpsychiatricinpatientoroutpatientcontactinDenmarkwereidentified ina
nationwideregister.
Results: Totally,354childrenandadolescentsgotadiagnosisofmania/bipolardisorderatleastonce;a
minority,144patients(40.7%)gotthediagnosisatthe firstcontactwhereastheremainingpatients(210;
59.3%)gotthediagnosisatlatercontactsbeforeage19.Forthelatterpatients,themediantimeelapsed
from firsttreatmentcontactwiththepsychiatricservicesystemtothe firstdiagnosiswithamanicepisode/
bipolardisorderwasnearly1yearandfor25%ofthosepatientsittookmorethan2½ yearsbeforethe
diagnosiswasmade.Themostprevalentotherdiagnosesthanbipolardisorderat firstcontactwere
depressivedisorder(21.4%),acuteandtransientpsychoticdisordersorothernon-organicpsychosis(19.2%),
reactiontostressoradjustmentdisorder(14.8%)andbehavioralandemotionaldisorderswithonsetduring
childhoodoradolescents(10.9%).Prevalenceratesofschizophrenia,personalitydisorders,anxietydisorder
or hyperkineticdisorders(ADHD)werelow.
Limitations: Dataconcernpatientswhogetcontacttohospitalpsychiatryonly.
Conclusions: Cliniciansshouldbemoreobservantonmanicsymptomsinchildrenandadolescentswhoat
firstglancepresentwithtransientpsychosis,reactiontostress/adjustmentdisorderorwithbehavioraland
emotionaldisorderswithonsetduringchildhoodoradolescents(F90–98)andfollowthesepatientsmore
closelyovertimeidentifyingputablehypomanicandmanicsymptomsasearlyaspossible.
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