Assessment of Pediatric Bipolar Disorder in Primary Care

Pediatric bipolar disorder (PBD) is a severe and often debilitating psychiatric condition that most often is diagnosed during later adolescence; though, rarely, it can occur in younger children. While it is strongly recommended that youth who present with concerns for PBD be referred to a specialist (eg, child and adolescent psychiatrist), pediatric primary care clinicians (PCCs) play an important role in the assessment of PBD, as delays in recognition of the disorder are associated with a more severe clinical course and poorer functional outcomes. Properly diagnosing PBD is made more difficult due to previous and ongoing disagreements in the PBD field regarding how the disorder presents in youth, especially prior to puberty. This article will address this controversy; review diagnostic criteria, epidemiology, and typical clinical course; and provide critical information that pediatric PCCs can incorporate into their assessment approach to improve their confidence and skills in diagnosing PBD.