Assessment of Childhood Bipolar Disorder

Barriers to the comprehensive clinical assessment of child-onset bipolar disorder (BPD) are numerous and include factors common to many pediatric diagnoses (e.g., disentangling comorbid conditions and overlapping symptoms; cross-situational variability in behavior; limited reliability of child report), as well as issues more specific to child-onset BPD (e.g., lack of empirically validated screening instruments; disagreement over age-specific symptom presentation and temporal discontinuity of symptoms). Thorough assessment includes careful consideration of differential diagnosis, investigation of familial history of affective illness, a focus on longitudinal data collection, and the use of multiple informants. Though a number of standardized measures may assist clinicians in gathering diagnostic information, clinical judgment based on familiarity with the unique presentation of child-onset BPD remains essential.