Case Western Reserve University researchers will gather information over the next five years from more than 1,600 families in the Cleveland area to help develop a tool to diagnose bipolar disorder in children as young as 5 years old—and potentially unite a psychological community divided over the probability of early onset.

Diagnosing bipolar disorder in children has split the psychological community into two camps, according to Eric Youngstrom, Case assistant professor of psychology, who is the lead researcher on a five-year, $2.3 million National Institute of Mental Health-funded study, "Assessing Bipolar Disorder: Assessing Community/Academic Blend."

Youngstrom said one group of psychology professionals believes the onset of bipolar disorder does not occur until the late teens and early 20s, while the other group thinks it appears more often than realized in children, with symptoms such as irritability and aggression exhibited in those as young as 2 years old.

"The diagnosis of bipolar disorder in children and adolescents is very controversial right now and, unfortunately, it is a high-stakes decision," Youngstrom said. "When children are misdiagnosed, they can have life-threatening side effects, which may further exacerbate their mental health welfare."

Bipolar disorder in its extreme form is characterized by deep depression and high energy, out-of-control episodes or a combination of the two extremes that can last for weeks or months. Left untreated, the disorder's episodes become more frequent and more resistant to change through medications and behavioral interventions.

The World Health Organization has described bipolar disorder as the leading causes of death and disabilities among mental health diseases. Those with bipolar disorder also are at risk for substance abuse, criminal behavior and suicide.

According to Youngstrom, the number of children with the disease, which has a genetic link and appears in its most severe form in about 2 percent of the adult population, is unknown.

"We probably only know about a tenth of the information about bipolar disorder in children as we do in adults," Youngstrom said. "Most of that information is based on diagnosis of children from white, middle class backgrounds."

Youngstrom will work on the study of low-income families with Robert Findling, Case associate professor of psychiatry, and Joseph Calabrese, Case professor of medicine, from the Stanley Medical Research Institute for Bipolar Disorder Across the Life Span at University Hospitals of Cleveland and Jen Youngstrom, a child psychologist from Applewood Centers Inc. in Cleveland and Case adjunct assistant professor of psychology.

"It is my hope that this project will enable clinicians to recognize the condition more accurately, diagnose it earlier and increase the services delivered to an underserved population," Eric Youngstrom said.

Return to the online edition of the 9-18-03 Campus News.