Bipolar Disorders in Children and Adolescents

Naomi A. Schapiro, RN, MS, CPNP


J Pediatr Health Care. 2005;19(3):131-141. 

In This Article

Psychotic Features: Mania or Schizophrenia?

Pediatric-onset bipolar disorder is associated with higher rates of psychosis than is found in persons with a later onset of BPD (Pavuluri, Herbener, & Sweeney, 2004). Delusions congruent with mania such as grandiosity are more common in pediatric BPD than in schizophrenia, whereas hallucinations and loosening of associations are more common in pediatric schizophrenia. Pavuluri and colleagues suggest that a psychotic presentation in BPD is underrecognized in children or mistakenly thought to be related to schizophrenia. Diagnosing disturbances in reality testing requires a developmental approach: looking at the age-appropriateness of the delusion and the child's reality-testing abilities, whether the child is acting on the thought, and any impairment in function caused by the delusion (Carlson, 1998). Some auditory hallucinations—such as hearing footsteps, knocking, or one's name—occur in persons without a psychiatric disorder (Pavuluri, Herbener, et al.).


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