Does DSM-IV BD exist in children and adolescents?
Using these assessment methods, can youth be identified who meet DSM-IV criteria for mania or hypomania? The answer to this question is clearly yes. The COBY (Course of Bipolar Youth) study, using assessment techniques like those described above, identified 255 children and adolescents with BD I and 30 with BD II, with a mean age of 12.9 ± 3.2y (Axelson et al., 2006; Birmaher et al., 2006). These subjects displayed a clearly episodic course: most (70%) of the subjects recovered from their index episode but 50% had at least one syndromal recurrence, usually depression. However, it is unclear exactly how common BD is in prepubertal children or, for that matter, adolescents. In the community-based Great Smoky Mountains Study (N = 1015) there were no cases of mania in children age 9-13 and the 3-month prevalence of hypomania was extremely low (.10 ± .6%) (Costello et al., 1996). Importantly, it is not yet clear whether and to what extent BD presents with different clinical features at diff
