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các tâm trạng trong 2 năm qua đã inCAUTION volved các triệu chứng hypomanic và triệu chứng trầm cảm (không đáp ứng criAlthough DSM-IV-TR đã được thêm vào teria cho MDD). nhiều tính năng liên quan và triệu chứng trầm cảm thời thơ ấu disorIn các đánh giá của văn học trong ders | MOOD DISORDERS 117 CAUTION Although the DSM-IV-TR has added many associated and symptom features for childhood depressive disorders MDD Dysthymic Disorder there is virtually no mention of how the bipolar disorders might manifest differently in children. However one specifier for the Bipolar Disorders that may be particularly relevant to childhood-onset bipolar is the rapid cycling specifier used when four or more mood episodes occur within a 12month period. Although this specifier is seen in approximately 10-20 of adult populations current literature suggests that this may be a predominant feature of Bipolar Disorder in children. ing mood for the past 2 years has involved hypomanic symptoms and depressive symptoms not meeting criteria for MDD . In their review of literature over the previous 10 years concerning child and adolescent Bipolar Disorder Geller and Luby 1997 suggest that childhood-onset Bipolar Disorder may be more severe be more chronic and have rapid-cycling features similar to the more severe types and often treatment-resistant forms of adult bipolar disorder. The mixed manic and rapid-cycling patterns may manifest as brief and multiple episodes which may cycle numerous times within a single day Geller et al. 1995 . In their literature review Geller and Luby 1997 provide examples of how the core features of a manic episode might be evident in childhood and adolescence. The following summary is based upon their review. In childhood rather than discrete episodes there are more likely to be rapid mood shifts between elation and irritability. A sense of childhood grandiosity or Putting It Into Practice Arthur was giggling wildly and running down the hall when his fifth-grade teacher cited him for breaking a school rule. When Arthur got to his desk he immediately threw his books on the floor and stamped his feet in protest.Time out did little to change his mood and Arthur glared at the other students while he huffed in the corner During this time out .
