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The emotional brain in youth
Date:9/4/2011

of mania, but shares with the narrower phenotypes the symptoms of severe irritability and ADHD-like hyperarousal. Indeed, these patients appear to better respond to pharmacological and non-pharmacological ADHD-like treatments (Waxmonsky et al., 2008).

This approach and subsequent research have given rise to the new diagnosis of Temper Dysregulation Disorder with Dysphoria (TDDD), which means a potential change in the diagnostic classification system DSM-V scheduled for publication in May 2013. However, a diagnosis of TDDD excludes the ADHD-like symptom of hyperarousal due to concerns that it would potentially lead to an increase in the diagnosis of ADHD. In general, such criteria have sparked an incredibly productive line of research demonstrating phenomenological differences (episodic vs. chronic course, euphoric vs. irritable mood) and initiating discussions that are relevant to clinicians and researchers alike (Dickstein, 2010; Leibenluft, 2011; Masi et al., 2008).

Treatment of bipolar disorder in youth

Pharmacological therapy

Appropriate treatment for children and adolescents with bipolar disorder has essential benefit with regard to school performance, academic or occupational impairment, relationship stress, comorbid substance use, and prevention of suicides. Pharmacotherapy of mania comprises so-called mood stabilizers (e.g. lithium), atypical or second-generation antipsychotics (SGAs) and typical antipsychotics (chlorpromazine). The use of mood stabilizers or antipsychotics in the treatment of children and adolescents appears to be of limited value when a comorbid condition such as ADHD occurs, unless aggressive behavior is the target symptom (Consoli et al., 2007).

Adverse subjective effects play a central role in the experience of taking antipsychotic drugs (Moncrieff et al., 2009). In adults, second-generation antipsychotics (SGAs) have shown a good benefice/risk ratio in bipolar disorder
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Contact: Sonja Mak
s.mak@update.europe.at
431-405-5734
European College of Neuropsychopharmacology
Source:Eurekalert

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