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Is Extreme Irritability - a Childhood Bipolar Disorder?

sic definition of BD (http://www.nimh.nih.gov/publicat/
bipolarupdate.cfm) includes extreme, sustained mood swings that range from over-excited, elated moods and irritability - the manic phase of the disorder - to depression. In contrast, children with SMD are extremely irritable and hyperactive, but do not have clear-cut manic episodes.

One component of irritability is the tendency to get acutely frustrated when a goal is not met. Thus, through electroencephalograms (EEGs), the researchers could observe the brain's electrical signals that occurred during frustration while children with either disorder performed simple tasks.

The new study shows that clinicians some day could use biological measurements, such as EEGs, to help make psychiatric diagnoses, in combination with clinical symptoms. Currently, clinicians diagnose mental illnesses based on symptoms alone. The difficulty of diagnosing BD in children is compounded by the frequent co-occurrence of one or more other mental disorders.

"We're approaching the day when we'll be able to use neuroscience techniques to improve psychiatric diagnoses. Pediatric BD has some of the most pressing needs in this regard, because of its severity and because of questions about how to best make the diagnosis," said senior author Ellen Leibenluft, M.D., Chief of the Unit on Bipolar Spectrum Disorders in the Emotion and Development Branch of the NIMH Mood and Anxiety Disorders Research Program.

In this study, scientists obtained EEGs of 35 children with classic BD, 21 children with SMD, and 26 healthy children (average age 12 to 13) while they performed a task repeatedly; each time they did the task, they won or lost 10 cents. The task was frustrating because the children often lost money.

The researchers found that while both the children with BD and those with SMD became more frustrated than did healthy children performing the same task, the brain mechanisms associated with t
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