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The clinical characteristics and adaptive functioning of preschoolers
who met DSM-IV criteria for bipolar disorder versus psychiatric
and healthy comparison groups were investigated. A community-based sample
of 303 preschoolers (3–6 years of age) and their caregivers was
ascertained. Diagnostic classification based on parent report of mania
symptoms was made using an age-appropriate psychiatric interview. Results
indicated that 26 preschoolers met DSM-IV criteria for bipolar
disorder who could be identified based the presence of 13 core
age-adjusted mania items. These children could be clearly differentiated
from children in two psychiatric groups (DSM-IV disruptive
disorders, and major depressive disorder) and a “healthy”
comparison group based on a specific symptom constellation. Findings
indicated that preschoolers in the bipolar group were significantly more
(p < .05) impaired than the two psychiatric and healthy groups
based on independent measures. Further, even after controlling for
comorbid attention-deficit/hyperactivity disorder (81% comorbidity
rate), the bipolar group remained significantly (p < .05) more
impaired in multiple domains compared to preschoolers with DSM-IV
disruptive disorders and healthy controls. Findings suggested that
children as young as 3 years can manifest DSM-IV bipolar disorder
when age adjusted symptom descriptions are employed, and that these
children can be distinguished from healthy and disruptive disordered
preschoolers. Recommendations for future research in this area that
integrates developmental and mental health models are made.
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