Bipolar Disorder in Childhood: A Diagnostic and Therapeutic Challenge: A Clinical Case Report

Abstract

Introduction: Bipolar disorder is generally thought to begin in adulthood. However, epidemiological and retrospective studies in adults diagnosed with bipolar disorder have shown that most individuals report the onset of their symptoms during adolescence, and a proportion even before adolescence. In children and adolescents, its clinical presentation may be confused with other diagnoses due to symptom overlap, such as attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD). Nevertheless, early identification and treatment are essential to prevent or reduce the risk of suicide, substance abuse and legal problems and ensure proper functioning in the child. Case report: This case report describes a twelve-year-old boy who began showing symptoms of bipolar disorder at the age of six. He had previously been diagnosed with ADHD. At age seven, following two years of close monitoring, he was diagnosed with bipolar I disorder. During this period, he exhibited episodes of worsening ADHD symptoms and behavioural disturbances suggestive of mania. Since then, he has been treated with valproic acid and stimulants, with good clinical progress. Discussion/Conclusions: Studies demonstrate the presence of bipolar disorder in children and adolescents, highlighting the importance of early diagnosis, as delayed diagnosis is associated with a poorer prognosis.