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The article presents a study that examines proposed disruptive mood dysregulation disorder (DMDD) diagnosis in a child psychiatric outpatient population. The domains covered by evaluation of DMDD include clinical phenomenology, delimitation from other diagnoses, longitudinal stability and association with parental psychiatric disorders. Concerns about the diagnostic utility of DMDD in clinical populations are highlighted by the study.

The article discusses a study which assessed the long-term efficacy of aripiprazole in children with bipolar disorder. Aripiprazole is an atypical antipsychotic, approved by the U.S. Food and Drug Administration (FDA) for the treatment of manic or mixed episodes with bipolar I disorder. The results indicate that aripiprazole may be superior to placebo in the long-term treatment of pediatric patients.

The article evaluates the possibility that the presence of persistent manic symptoms over a short interval among youth may increase the probability of a bipolar spectrum disorders (BPSD) diagnosis. Youth were assessed for elevated symptoms of mania (ESM) with the Parent General Behavior Inventory-10-Item Mania Scale (PGBI-10M) as the primary outcome measure. The article concludes that the probability of a BPSD diagnosis was substantially altered by obtaining repeated parent report of mania symptoms in many cases.

This article discusses a study which examined the differences in psychiatric symptomatology, diagnoses, demographics, functioning and psychotropic medication exposure in children with elevated symptoms of mania (ESM) compared to youth without ESM. A review of previous related literature is included. The data, methods and results of the study are explored.

The article presents a longitudinal study of youth diagnosed with elevated symptoms of mania (ESM). For the study, researchers examined the rate and sociodemographic correlates of ESM in children admitted to outpatient psychiatric clinics. They found no sociodemographic differences between children who did versus those who did not agree to enroll in the longitudinal portion. They observed that children with ESM demonstrated behavioral extremes.

Objective: To determine if divalproex sodium was superior to placebo in the treatment of symptomatic youths who suffer from a bipolar spectrum disorder and who also have a parent with a diagnosis of a bipolar illness., Method: Youths, ages 5 to 17 years, meeting DSM-IV criteria for bipolar disorder not otherwise specified (NOS) or cyclothymia who also had at least 1 biological parent with bipolar illness were randomly assigned in a double-blind fashion to receive treatment with either dival-proex sodium or placebo for up to 5 years. Study participation ended if the subject required additional clinical intervention, if the patient developed treatment-related adverse events, or if the participant was not adherent with study procedures. The primary outcome measure was time to study discontinuation for any reason. The study was conducted from August 1997 to April 2003., Results: Fifty-six youths with a mean (SD) age of 10.7 (3.1) years were randomly assigned and received either divalproex sodium (N = 29) or placebo (N = 27). In spite of statistical power of 80% to detect hazard ratios of 2.2 or larger, the treatment groups did not significantly differ in survival time for discontinuation for any reason (p = .93) or discontinuation due to a mood event (p = .55). Changes in mood symptom ratings and psychosocial functioning from baseline to study discontinuation did not differ between groups (most significant p > .14). However, both groups did show improvements in mood symptoms and psychosocial functioning over time (all p values < .002). One patient, from the placebo group, ended study participation due to an adverse event., Conclusion: These results suggest that, although well tolerated, divalproex sodium does not produce clinically meaningful improvements in the treatment of symptomatic youths suffering from either bipolar NOS or cyclothymia who are at genetic risk for developing bipolar disorder.