Psychosis in Bipolar Disorder
Introduction
Preoperational children (age 2-7) will present with stress-associated hallucinations that are tactile or visual.
Psychosis in bipolar disorder
Psychosis can occur in either pole of the disorder
DSM IV: 2 weeks of psychotic sx during mood episode is sufficient to convert a dx of bipolar or major depressive disorder into schizoaffective disorder.
In addition, among children and adolescents, the diagnosis of bipolar disorder is often complicated by less consistent mood and behavior baseline than occurs in adults.
Clinical presentation of a pt at the height of a manic episode may be indistinguishable from that of an acute exacerbation of paranoid schizophrenia, making accurate dx difficult.
A subsequent major depressive episode or manic episode that initially presents with mood sx prior to the onset of psychosis indicates that a mood disorder, rather than a psychotic disorder, is present.
Psychotic-like sx have also been reported in other psychiatric disorders such as anxiety, PD, substance abuse, and PTSD and in medical/neurological illnesses such as seizures or migraines.
Treatment
Treatment of bipolar with psychosis in children and adolescents generally use the same pharmacological agents as adults with same condition.
References
Geller, Barbara, and Joan Luby. Child and Adolescent Bipolar Disorder: A review of the past 10 years. J. Am. Acad. Child Psychiatry, 36:9, Sept 1997.
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