Bipolar Disorder in Youth Bipolar Disorder in Youth Presentation, Treatment, and Neurobiology EDITED BY Stephen M. Strakowski, MD Senior Vice President Strategy & Transformation, UC Health Professor of Psychiatry & Behavioral Neuroscience Psychology & BME, UC University of Cincinnati College of Medicine, Cincinnati, OH Melissa P. DelBello, MD, MS Professor of Psychiatry and Pediatrics Dr. Stanley and Mickey Kaplan Professor and Chair Department of Psychiatry and Behavioral Neuroscience University of Cincinnati College of Medicine, Cincinnati, OH Caleb M. Adler, MD Professor and Vice-Chair for Clinical Research Department of Psychiatry and Behavioral Neuroscience Co-Director, Division of Bipolar Disorders Research University of Cincinnati College of Medicine, Cincinnati, OH 1 1 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. 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Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data Bipolar disorder in youth : presentation, treatment, and neurobiology / edited by Stephen M. Strakowski, Melissa P. DelBello, Caleb M. Adler. p. ; cm. Includes bibliographical references. ISBN 978–0–19–998535–7 (alk. paper) I. Strakowski, Stephen M., editor. II. DelBello, Melissa P., editor. III. Adler, Caleb M., editor. [DNLM: 1. Bipolar Disorder—diagnosis. 2. Bipolar Disorder—therapy. 3. Adolescent. 4. Diagnosis, Differential. 5. Risk Factors. WM 207] RC516 616.89'5—dc23 2014019807 This material is not intended to be, and should not be considered, a substitute for medical or other professional advice. Treatment for the conditions described in this material is highly dependent on the individual circumstances. And, while this material is designed to offer accurate information with respect to the subject matter covered and to be current as of the time it was written, research and knowledge about medical and health issues is constantly evolving and dose schedules for medications are being revised continually, with new side effects recognized and accounted for regularly. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation. The publisher and the authors make no representations or warranties to readers, express or implied, as to the accuracy or completeness of this material. Without limiting the foregoing, the publisher and the authors make no representations or warranties as to the accuracy or efficacy of the drug dosages mentioned in the material. The authors and the publisher do not accept, and expressly disclaim, any responsibility for any liability, loss or risk that may be claimed or incurred as a consequence of the use and/or application of any of the contents of this material. 9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper Contents Contributors vii Prologue xi section 1. Phenomenology and Diagnosis Section Editor: Caleb M. Adler 1. Progression of Bipolar Disorder in Youth: Defining the Early Clinical Stages in the Development of Bipolar Disorder 3 Anne Duffy 2. Presentation of Mania/Bipolar I in Youth: Comparison With Adults 13 Gabrielle A. Carlson and Caroly Pataki 3. Differential Diagnosis of Bipolar Disorder in Children and Youth 34 Kenneth E. Towbin and Ellen Leibenluft 4. Comorbid Conditions in Youth With and At Risk for Bipolar Disorder 56 Gagan Joshi and Timothy Wilens 5. Heritability of Bipolar Disorder 94 Katie Mahon, Katherine E. Burdick, and Anil K. Malhotra 6. Nonheritable Risk Factors for Bipolar Disorder 109 Robert K. McNamara and Jeffrey R. Strawn section 2. Treatment of Bipolar Disorder in Youth Section Editor: Melissa P. DelBello 7. Ethical Consideration for Treating At-Risk Populations 133 Aswin Ratheesh, Michael Berk, and Patrick D. McGorry vi | Contents 8. Medical Treatment Strategies for Young People With Bipolar Disorder 156 Sarah M. Lytle, Sonal K. Moratschek, and Robert L. Findling 9. Psychotherapeutic Strategies for Treating Youth With or At Risk for Bipolar Disorder 189 David J. Miklowitz 10. Complementary and Alternative Medicine in Child and Adolescent Bipolar Disorder 205 Barbara L. Gracious, Sathyan Gurumurthy, Alexandra Cottle, and Taylor M. McCabe section 3. Neurobiology of Bipolar Disorder Section Editor: Stephen M. Strakowski 11. Neurobiology of Developing Bipolar Disorder 243 Jillian M. Russo, Sonja M. C. de Zwarte, and Hilary P. Blumberg 12. Neurobiology of Bipolar Disorder in Youth: Brain Domain Dysfunction is Translated to Decode the Pathophysiology and Understand the Nuances of the Clinical Manifestation 282 Mani N. Pavuluri 13. Neurocognitive Models of Evolving Bipolar Disorder in Youth 305 Alessandra M. Passarotti 14. The Neural Effects of Intervention in Pediatric Bipolar Disorder 334 Manpreet K. Singh and Kiki D. Chang 15. Integration and Future Direction: Toward Improving Outcomes for Youth With Bipolar Disorder 348 Luis Rodrigo Patino Duran, Peirce Johnston, Caleb M. Adler, Melissa P. DelBello, and Stephen M. Strakowski Index 361 Contributors Caleb M. Adler, MD Stony Brook University School of Department of Psychiatry & Behavioral Medicine Neuroscience Stony Brook, NY University of Cincinnati College of Kiki D. Chang, MD Medicine Department of Psychiatry and Behavioral Cincinnati, OH Sciences Michael Berk, MD, PhD Stanford University School of Medicine Department of Psychiatry Stanford, CA Deakin University School of Alexandra Cottle Medicine Center for Innovation in Pediatric Geelong, Australia Practice Hilary P. Blumberg, MD The Ohio State University Department of Psychiatry Columbus, OH Yale University School of Medicine Anne Duffy, MD New Haven, CT Department of Psychiatry Katherine E. Burdick, PhD Calgary University Departments of Psychiatry and Calgary, Alberta, Canada Neuroscience Melissa P. DelBello, MD, MS Icahn School of Medicine at Department of Psychiatry & Behavioral Mount Sinai Neuroscience New York, NY University of Cincinnati College of Gabrielle A. Carlson, MD Medicine Department of Psychiatry Cincinnati, OH viii | Contributors Robert L. Findling, MD, MBA University Hospitals Case Medical Department of Psychiatry and Center Behavioral Sciences Cleveland, OH Johns Hopkins University, and Katie Mahon, PhD Vice President of Psychiatry Services and Departments of Psychiatry and Research Neuroscience Kennedy Krieger Institute Icahn School of Medicine at Baltimore, MD Mount Sinai Barbara L. Gracious, MD New York, NY Center for Innovation in Pediatric Anil K. Malhotra, MD Practice Department of Psychiatry Research The Research Institute at Nationwide The Zucker Hillside Hospital Children's Hospital Glen Oaks, NY The Ohio State University and Columbus, OH The Feinstein Institute for Medical Sathyan Gurumurthy, MD Research Department of Psychiatry Manhasset, NY The Ohio State University Taylor M. McCabe, SN/STNA Columbus, OH Ohio Northern University Peirce Johnston, MD Ada, OH Department of Psychiatry & Behavioral Patrick D. McGorry, MD, PhD Neuroscience Department of Psychiatry University of Cincinnati College of Centre for Youth Mental Health Medicine University of Melbourne Cincinnati, OH Melbourne, Australia Gagan Joshi, MD Robert K. McNamara, PhD Department of Psychiatry Department of Psychiatry and Massachusetts General Hospital Behavioral Neuroscience Boston, MA University of Cincinnati College of Ellen Leibenluft, MD Medicine Section on Bipolar Spectrum Disorders Cincinnati, OH Emotion and Development David J. Miklowitz, PhD National Institute of Mental Health Division of Child and Adolescent Bethesda, MD Psychiatry Sarah M. Lytle, MD, MS David Geffen School of Medicine at Division of Child and Adolescent UCLA Psychiatry Los Angeles, CA Contributors | ix Sonal K. Moratschek, MD, MPH Manpreet K. Singh, MD, MS Division of Child and Adolescent Department of Psychiatry and Psychiatry Behavioral Sciences University Hospitals Case Medical Stanford University School of Medicine Center Stanford, CA Cleveland, OH Stephen M. Strakowski, MD Alessandra M. Passarotti, PhD Department of Psychiatry & Behavioral Department of Psychiatry Neuroscience University of Illinois at Chicago University of Cincinnati College of Chicago, IL Medicine Cincinnati, OH Caroly Pataki, MD Department of Psychiatry and Jeffrey R. Strawn, MD Biobehavioral Sciences Department of Psychiatry and Behavioral David Geffen School of Medicine Neuroscience at UCLA University of Cincinnati College of Los Angeles, CA Medicine Cincinnati, OH Luis Rodrigo Patino Duran, MD Department of Psychiatry & Behavioral Kenneth E. Towbin, MD Neuroscience Emotion and Development University of Cincinnati College of Branch Medicine National Institute of Mental Cincinnati, OH Health U.S. Department of Health and Human Mani N. Pavuluri, MD, PhD Services Department of Psychiatry Bethesda, MD University of Illinois at Chicago Chicago, IL Timothy Wilens, MD Aswin Ratheesh, MD Department of Psychiatry Centre for Youth Mental Health Massachusetts General Hospital University of Melbourne Harvard Medical School Melbourne, Australia Boston, MA Jillian M. Russo, PsyD Sonja M. C. de Zwarte, MS Department of Psychiatry Department of Psychiatry Yale University School of Yale University School of Medicine Medicine New Haven, CT New Haven, CT