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Psychotic phenomena in 257 young children and adolescents with bipolar I disorder: delusions and hallucinations (benign and pathological)
Author(s) -
Tillman Rebecca,
Geller Barbara,
Klages Tricia,
Corrigan Meg,
Bolhofner Kristine,
Zimerman Betsy
Publication year - 2008
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2008.00480.x
Subject(s) - grandiosity , delusion , mania , psychology , bipolar disorder , psychosis , schedule for affective disorders and schizophrenia , pathological , psychiatry , schizophrenia (object oriented programming) , clinical psychology , pediatrics , medicine , mood , psychoanalysis , anxiety , narcissism
Objectives: In contrast to studies of adult bipolar I disorder (BP‐I), there is a paucity of data on psychotic phenomena in child BP‐I. Therefore, the aim of this work was to describe delusions and hallucinations in pediatric BP‐I. Methods: Subjects were 257 participants, aged 6–16, in either of two large, ongoing, NIMH‐funded studies, ‘Phenomenology and Course of Pediatric Bipolar Disorders’ or ‘Treatment of Early Age Mania (TEAM)’. All subjects had current DSM‐IV BP‐I (manic or mixed phase) with a Children’s Global Assessment Scale score ≤60 (definite clinical impairment), and all had cardinal mania symptoms (i.e., elation and/or grandiosity). Comprehensive assessments included the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH‐U‐KSADS), which was administered to parents about their children and separately to children about themselves by experienced research clinicians. The WASH‐U‐KSADS contains modules for developmentally child‐age‐specific manifestations of numerous categories of psychotic phenomena. Results: Psychosis was present in 76.3% (n = 196) of subjects, which included 38.9% (n = 100) with delusions, 5.1% (n = 13) with pathological hallucinations, and 32.3% (n = 83) with both. The most common delusion was grandiose (67.7%, n = 174), and the most common pathological hallucination was visual (16.0%, n = 41). Benign hallucinations occurred in 43.6% (n = 112). A median split by age yielded 6–9 year‐olds (n = 139) and 10–16 year‐olds (n = 118). Analyses of these two groups, and of 6, 7, 8, and 9 year‐olds separately, found no significant differences in psychotic phenomena. Conclusions: Counterintuitively, psychosis was equally prevalent in 6–9 compared to 10–16 year‐olds. High prevalence of psychosis in child BP‐I warrants focus in intervention strategies and is consistent with increasing evidence of the severity of child‐versus adult‐onset BP‐I.