Treatment of Bipolar Disorder in Children and Adolescents

433 Pages·2008·3.22 MB·English

by  Barbara Geller MD

TREATMENT OF BIPOLAR DISORDER
IN CHILDREN AND ADOLESCENTS

Treatment of Bipolar
Disorder in Children
and Adolescents
Edited by
BARBARA GELLER
MELISSA P. DELBELLO
THE GUILFORD PRESS
New York London
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LibraryofCongressCataloging-in-PublicationData
Treatmentofbipolardisorderinchildrenandadolescents/editedbyBarbaraGeller,
MelissaP.DelBello.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN:978-1-59385-678-6(hardcover:alk.paper)
1. Manicdepressiveillnessinchildren—Treatment.2. Manicdepressiveillnessin
adolescence—Treatment. I.Geller,Barbara.II.DelBello,MelissaP.
[DNLM:1. BipolarDisorder—drugtherapy. 2. Adolescent. 3. BipolarDisorder—
complications. 4. BipolarDisorder—psychology. 5. Child. WM207T7842008]
RJ506.D4T772008
618.92′895—dc22
2008004582
AAbboouutt tthhee EEddiittoorrss
About the Editors
BarbaraGeller,MD,isProfessorofPsychiatryatWashingtonUniversityin
St. Louis. An internationally recognized researcher for studies of child and
adolescentbipolardisorders,Dr.Gellerisprincipalinvestigatoronmultiple
National Institute of Mental Health-funded projects. Dr. Geller earned her
medicaldegreefromAlbertEinsteinCollegeofMedicineinNewYork,and
completed her residency and fellowship at New York University–Bellevue
Medical Center. She has served on numerous federal advisory committees,
editorialboards,andadvocacygroupscientificadvisoryboards.Among her
awardsaretheAmericanAcademyofChildandAdolescentPsychiatryNa-
than Cummings Special Research Award and the National Alliance on
Mental Illness Exemplary Psychiatrist Award. Widely published, Dr. Geller
has written more than 125 articles on diagnosticcharacteristics,phenomen-
ology,longitudinalcourse,familypsychopathology,molecular genetics, and
pharmacological treatment of pediatric manic–depressive disorders.
Melissa P. DelBello, MD, MS, is Associate Professor of Psychiatry and Pe-
diatrics,Vice-ChairforClinicalResearch,andCodirectoroftheDivisionof
BipolarDisordersResearchattheUniversityofCincinnatiCollegeofMedi-
cine.SheisalsoDirector,ResearchEducationandTraining,ChildandAdoles-
centPsychiatryDivision,atCincinnatiChildren’sHospitalMedicalCenter.
Dr. DelBello earned her medical degree with honors from the University of
Rochester School of Medicine in Rochester, New York. She completed her
residency in psychiatry at the Payne Whitney Clinic, New York Hospital–
Cornell Medical Center, and at the University of Cincinnati College of
Medicine,andafellowshipinChildandAdolescentPsychiatryatCincinnati
Children’s Hospital Medical Center. Dr. DelBello is the author or coauthor
of over 100 journal articles or chapters, and her primary research interests
include neuropharmacology and neurodevelopment of pediatric bipolar
disorder.
v
CCoonnttrriibbuuttoorrss
Contributors
Shannon Rae Barnett, MD, is Assistant Professor of Psychiatry in the Division of
Child and Adolescent Psychiatry at the Johns Hopkins University School of Medicine
in Baltimore, Maryland. Dr. Barnett has worked on several multisite studies focusing
on mood disorders in children and adolescents, including the Treatment of Early Age
Mania, the Treatment for Adolescents with Depression Study, and the Treatment of
Adolescent Suicide Attempters. In addition, Dr. Barnett is the Director of Adolescent
Psychiatry Services at Johns Hopkins Bayview Medical Center, where she leads a
treatment team with an emphasis on treating adolescents with mood disorders.
Samantha Blankenship, MSW, is the study monitor for the Treatment of Early Age
Mania study at Washington University and has contributed to the work on the
Pediatric Depression Study. She specializes in education and clinical research with
young children and families, including intensive training in therapeutic interventions
with preschool- and school-age children. Through her work at the Early Emotional
Development Program at Washington University, Ms. Blankenship has coauthored
multiple articles on preschool mood disorders.
Hallie R. Bregman, BA, is a research coordinator at the Child and Adolescent
Neuropsychiatric Research Program at Cambridge Health Alliance, Cambridge,
Massachusetts. She earned her bachelor’s degree with honors in psychology from the
University of Delaware, where she was awarded the Psychology Research Award in
2006.
Kiki D. Chang, MD, is Associate Professor of Psychiatry and Behavioral Sciences at
the Stanford University School of Medicine, Division of Child Psychiatry. He is
Director of the Pediatric Bipolar Disorders Clinic and Research Program, where he
specializes in pediatric psychopharmacology and treatment of depression and bipolar
disorder in children and adolescents. His research includes brain imaging, genetics,
and medication and psychotherapy trials, with a special focus on early identification
and prevention of bipolar disorder. Dr. Chang is the author of over 50 papers and
book chapters regarding bipolar disorder.
vi
Contributors vii
Christoph U. Correll, MD, is Assistant Professor of Psychiatry and Behavioral
Sciences, Albert Einstein College of Medicine, Bronx, New York. He has been
working as a research psychiatrist at the Zucker Hillside Hospital, where he is the
Medical Director of the Recognition and Prevention Program, a National Institute of
Mental Health-funded research program for the early identification and treatment of
youth at risk for psychosis. His research focuses on early-phase psychotic and bipolar
disorders and the risk–benefit evaluation of psychotropic medications, particularly
antipsychotics and mood stabilizers. He has received more than 20 research awards
and has authored numerous articles in the area of the psychotic and bipolar
prodrome, as well as adverse effects of antipsychotics in youth and adults.
Kristen H. Davidson, PhD, is in private practice in Rochester, New York, and is a
clinical senior instructor in the Departments of Psychiatry and Pediatrics at the
University of Rochester Medical Center. She has authored several articles and book
chapters on the assessment and treatment of childhood mood disorders.
Melissa P. DelBello, MD, MS (see “About the Editors”).
Robert L. Findling, MD, is the Director of the Division of Child and Adolescent
Psychiatry at University Hospitals Case Medical Center and Professor of Psychiatry
and Pediatrics at Case Western Reserve University. He is both a child and adolescent
psychiatrist as well as a pediatrician. Dr Findling’s research endeavors have focused
on pediatric psychopharmacology and psychotic disorders in children. He has been
honored with numerous awards and has received international recognition as a
clinical investigator. Dr. Findling is the principal investigator of a National Institute of
Child Health and Human Development contract examining lithium in the treatment
of pediatric mania and also the principal investigator of a National Institue of Mental
Health study assessing the longitudinal course of children with symptoms of mania.
Jean A. Frazier, MD, is the Director of Child Psychopharmacology and the Child and
Adolescent Neuropsychiatric Research Program at Cambridge Health Alliance, where
she is also Codirector of the Center for Child and Adolescent Development. Dr.
Frazier is Associate Professor of Psychiatry at Harvard Medical School and is
internationally known for her work with children with serious mental illness and
those with developmental disabilities. She has published over 70 articles and book
chapters and has won numerous awards, including the Annual Exemplary Psychiatrist
Award from the National Alliance on Mental Illness and the Outstanding Psychiatrist
Award for Research from the Massachusetts Psychiatric Society.
Mary A. Fristad, PhD, is Professor of Psychiatry and Psychology at The Ohio State
University (OSU) and the Director of Research and Psychological Services in the OSU
Division of Child and Adolescent Psychiatry. Dr. Fristad has published over 125
articles and book chapters addressing the assessment and treatment of childhood-
onset depression, suicidality, and bipolar disorder. She edited the Handbook of
Serious Emotional Disturbance in Children and Adolescents and has written a book
for families entitled Raising a Moody Child: How to Cope with Depression and
Bipolar Disorder. Dr. Fristad serves on the board of directors for five web-based
education and support groups for children and families with mood disorders. She has
been the principal or co-principal investigator on over two dozen federal, state, and
local grants, all focusing on the assessment and/or treatment of childhood-onset mood
disorders.
viii Contributors
Barbara Geller, MD (see “About the Editors”).
Martin Gignac, MD, FRCP, has been working as a psychiatrist and clinical research
coordinator at the adolescents’ unit of the Institut Philippe-Pinel de Montréal, where
he is also head of the outpatient clinic for severe disruptive disorders in adolescence.
In addition, he has been involved in several studies and published articles and book
chapters in the field of pediatric psychopharmacology.
Joseph A. Jackson, DO, is Instructor in Psychiatry at Harvard Medical School and
the Medical Director of the Developmental Disabilities Program at the Center for
Child and Adolescent Development, Cambridge Health Alliance. His expertise is in
working with children with multicomplex disorders, particularly those with comorbid
pervasive developmental disorders and bipolar disorder.
Gagan Joshi, MD, is a clinical and research psychiatrist and the Scientific Director of
the Pervasive Developmental Disorders Research Program in the Pediatric
Psychopharmacology Unit at Massachusetts General Hospital and Instructor in
Psychiatry at Harvard Medical School. Dr. Joshi’s clinical and research interest is in
pediatric bipolar disorder and pervasive developmental disorders, with particular
focus on the comorbid conditions associated with these disorders. Besides conducting
research, he also takes care of youth with these conditions in his clinical practice at
Massachusetts General Hospital. He received the prestigious Ethel Dupont Warren
Fellowship Award through the Department of Psychiatry at Harvard Medical School,
the Norma Fine Fellowship, the 25th Collegium Internationale Neuro-
Psychopharmalogicum Congress Young Investigators Award, and the American
Academy of Child and Adolescent Psychiatry Pilot Research Award.
Paramjit T. Joshi, MD, is the Endowed Chair of the Department of Psychiatry and
Behavioral Sciences at the Children’s National Medical Center and Professor of
Psychiatry, Behavioral Sciences, and Pediatrics at the George Washington University
School of Medicine in Washington, DC. She is a Distinguished Fellow of the
American Psychiatric Association and a recipient of its Bruno Lima award for
outstanding contributions in the care and understanding of disaster psychiatry, as well
as of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness.
She has held several national offices with the American Academy of Child and
Adolescent Psychiatry and the American Board of Psychiatry and Neurology and
currently is the President of the Society of Professors of Academic Programs of Child
and Adolescent Psychiatry (2006–2008). She has taught and published extensively on
mood disorders, psychopharmacology, and childhood trauma.
Robert A. Kowatch, MD, PhD, is Professor of Psychiatry and Pediatrics at Cincinnati
Children’s Hospital Medical Center. Dr. Kowatch has authored or coauthored more
than 50 articles, 14 book chapters, and one book. He has published in the areas of
the diagnosis and treatment of children and adolescents with bipolar disorder, sleep
disorders, and depression. His articles have been published in the Journal of the
American Academy of Child and Adolescent Psychiatry, Neuropsychopharmacology,
Archives of General Psychiatry, and the Journal of Child Neurology, among others.
He is a member of the American Academy of Child and Adolescent Psychiatry, the
Society for Biological Psychiatry, and the American College of Neuropharmacology,
and his research interests are in the diagnosis, treatment, and neurobiology of child
and adolescent mood disorders.
Contributors ix
Joan L. Luby, MD, is an infant preschool psychiatrist and Associate Professor of
Child Psychiatry at the Washington University School of Medicine in St. Louis, where
she is the founder and director of the Early Emotional Development Program. Dr.
Luby has been awarded grants from the National Institute of Mental Health and the
National Alliance for Schizophrenia and Depression, which have supported her
program of research on the phenomenology of early-onset mood disorders. Findings
from these studies have been widely published in both child and adult psychiatric
journals, and she has been the recipient of several awards, including the Gerald
Klerman award for outstanding research in depression. Dr. Luby has committed her
career to the study and clinical assessment and treatment of preschool children. She
currently chairs the Infancy Committee of the American Academy of Child and
Adolescent Psychiatry.
Molly McGrath, LCSW, is a research clinician with the Early Emotional Development
Program at Washington University. She has contributed to the work on the Pediatric
Depression Study and the Treatment of Early Age Mania study. As a teaching
assistant at Washington University’s George Warren Brown School of Social Work,
Ms. McGrath lectures and facilitates discussions in courses on the foundations of
social work practice. She also serves as a mental health consultant providing
resources, referrals, behavioral observations, and inservice training for staff at an
Early Head Start facility in the St. Louis area.
David J. Miklowitz, PhD, is Professor of Psychology and Psychiatry at the University
of Colorado at Boulder and a Senior Clinical Research Fellow in the Department of
Psychiatry at Oxford University. His research focuses on family environmental factors
and family psychoeducational treatments for adult- and childhood-onset bipolar
disorder. He developed the family psychoeducational intervention known as “family-
focused treatment” for adults and youth with bipolar disorder. Dr. Miklowitz has
received awards from the University of California, Los Angeles; the International
Congress on Schizophrenia Research; the National Alliance for Research on
Schizophrenia and Depression; the University of Colorado; the International Society
for Bipolar Disorders. He has received funding for his research from the National
Institute of Mental Health, the John D. and Catherine T. MacArthur Foundation, the
Robert Sutherland Foundation, and the Danny Alberts Foundation. Dr. Miklowitz has
published more than 170 research articles and book chapters on bipolar disorder and
schizophrenia, and five books, including The Bipolar Disorder Survival Guide.
Kimberley L. Mullen, MA, is a doctoral candidate in clinical psychology at the
University of Colorado at Boulder and has contributed to the research on family-
focused treatment (FFT) for adolescents diagnosed with bipolar disorder. She
currently works at the Denver Veterans Affairs Medical Center, where she provides
clinical services and conducts research on the application of FFT for families of
returning Iraq or Afghanistan veterans with posttraumatic stress disorder.
Nick C. Patel, PharmD, PhD, is Assistant Professor of Pharmacy at the University of
Georgia, and of Psychiatry at the Medical College of Georgia. His research interests
are the pharmacological treatment of child and adolescent mood disorders and
neuropsychopharmacology using magnetic resonance spectroscopy. He has authored
or coauthored numerous articles in these areas.
Jennifer Pautsch, MA, is Study Coordinator for the Early Intervention in Depression
Study, which is piloting PCIT-ED, the parent–child interaction therapy–emotional