Once considered rare in children, recent studies have indicated a sharp increase in the number of children diagnosed with bipolar disorder in both inpatient and outpatient settings.(4–8) Children with bipolar disorder have significantly higher rates of morbidity and mortality than children without the disorder,(9) including psychosocial morbidity, impaired academic performance, impaired social and familial support, increased levels of substance abuse, weight problems, legal difficulties, and hospitalizations.(10–14) Although the criteria for diagnosing and the use of the bipolar diagnostic label among children with non-classical symptom presentations is a matter of clinical debate, (14, 15) a growing number of children over recent years have received these diagnoses and related treatment.
