E-ISSN 2636-834X
 

Review Article 


Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities

Ayfer Orhan, Osman Abalý.

Abstract
Bipolar disorder, the course of which shows alterations between depressive and elated moods, is a chronic psychiatric disorder impairing the patients’ psychosocial functioning dramatically. Childhood bipolar disorder, which has recently begun to be researched, is a clinical condition that represents some differences than the adult type bipolar disorder. These differences mostly mislead the clinicians and cause diagnostic confusion. Therefore, diagnostic consistency and good understanding of co-morbid disorders are important from the treatment perspective. Particularly the comorbidities and various clinical presentations may prevent clinicians from reaching correct treatment strategies. Diagnostic consistency and comorbidities of bipolar disorder in children and adolescents were reviewed in this article.

Key words: Bipolar disorder, psychiatry, adolescence, childhood, comorbidity


 
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REFERENCES
1. Luckenbaugh DA, Findling RL, Leverich GS, Pizzarello SM, Post RM. Earliest symptoms discriminating juvenile-onset bipolar illness from ADHD. Bipolar Disord 2009; 11: 441-51. [DOI via Crossref]    [Pubmed]   
2. Mick E, Spencer T, Wozniak J, Biederman J. Heterogeneity of irritability in attention-deficit/hyperactivity disorder subjects with and without mood disorders. Biol Psychiatry 2005; 58: 576-82. [DOI via Crossref]    [Pubmed]   
3. Kovacs M, Pollock M. Bipolar disorder and comorbid conduct disorder in childhood and adolescence. J Am Acad Child Adolesc Psychiatry 1995; 34: 715-23. [DOI via Crossref]    [Pubmed]   
4. Swann AC. The strong relationship between bipolar and substance-use disorder. Ann N Y Acad Sci 2010; 1187: 276-93. [DOI via Crossref]    [Pubmed]   
5. Chambers WJ, Puig-Antich J, Tabrizi MA, Davies M. Psychotic symptoms in prepubertal major depressive disorder. Arch Gen Psychiatry 1982; 39: 921-7. [DOI via Crossref]    [Pubmed]   
6. McClellan J, McCurry C. Early onset psychotic disorders: Diagnostic stability and clinical characteristics. European Child & Adolescent Psychiatry 1999; 8: I/13-I/19.
7. McKenna K, Gordon CT, Lenane M, Kaysen D, Fahey K, Rapoport JL. Looking for childhood-onset schizophrenia: the first 71 cases screened. J Am Acad Child Adolesc Psychiatry 1994; 33: 636-44. [DOI via Crossref]    [Pubmed]   
8. Ruggero CJ, Carlson GA, Kotov R, Bromet EJ. Ten-year diagnostic consistency of bipolar disorder in a first-admission sample. Bipolar Disord 2010; 12: 21-31. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
9. Faraone SV, Sergeant J, Gillberg C, Biederman J. The worldwide prevalence of ADHD: is it an American condition? World Psychiatry 2003; 2: 104-113. [Pubmed]    [PMC Free Fulltext]   
10. Emiroðlu FN, Bozabalý ÖG. Çocukluk ve Ergenlik Çaðý Bipolar Bozukluðu Taný ve Ayýrýcý Taný. Çocuk ve Ergen Ruh Saðlýðý Dergisi 2002; 9: 178-189.
11. Cahill C, Hanstock T, Jairam R, Hazell P, Walter G, Malhi GS. Comparison of diagnostic guidelines for juvenile bipolar disorder. Aust N Z J Psychiatry 2007; 41: 479-84. [DOI via Crossref]    [Pubmed]   
12. Lewinsohn PM, Klein DN, Seeley JR. Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity,and course. J Am Acad Child Adolesc Psychiatry 1995; 34: 454-63. [DOI via Crossref]    [Pubmed]   
13. Leverich GS, Post RM, Keck PE Jr, Altshuler LL, Frye MA, Kupka RW, Nolen WA, Suppes T, McElroy SL, Grunze H, Denicoff K, Moravec MK, Luckenbaugh D. The poor prognosis of childhoodonset bipolar disorder. J Pediatr 2007; 150: 485-490. [DOI via Crossref]    [Pubmed]   
14. Egeland JA, Hostetter AM, Pauls DL, Sussex JN. Prodromal symptoms before onset of manic-depressive disorder suggested by first hospital admission histories. J Am Acad Child Adolesc Psychiatry 2000; 39: 1245-1252. [DOI via Crossref]    [Pubmed]   
15. Pavuluri MN, Birmaher B, Naylor MW. Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2005; 44: 846-71. [DOI via Crossref]    [Pubmed]   
16. Perlis RH, Miyahara S, Marangell LB. Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Biol Psychiatry 2004; 55: 875-881. [DOI via Crossref]    [Pubmed]   
17. Axelson D, Birmaher B, Strober M, Gill MK, Valeri S, Chiappetta L, Ryan N, Leonard H, Hunt J, Iyengar S, Bridge J, Keller M. Phenomenology of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry 2006; 63: 1139-1148. [DOI via Crossref]    [Pubmed]   
18. Saxena K, Nakonezny PA, Simmons A, Mayes T, Walley A, Emslie G. Outpatient diagnosis and clinical presentation of bipolar youth. J Can Acad Child Adolesc Psychiatry 2009; 18: 215-20. [Pubmed]    [PMC Free Fulltext]   
19. Galanter CA, Pagar DL, Oberg PP, Wong C, Davies M, Jensen PS. Symptoms leading to a bipolar diagnosis: a phone survey of child and adolescent psychiatrists. J Child Adolesc Psychopharmacol 2009; 19: 641-7. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
20. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): inicial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36: 980-8. [DOI via Crossref]    [Pubmed]   
21. Geller B, Zimerman B, Williams M, Bolhofner K, Craney JL, DelBello MP, Soutullo C. Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections. J Am Acad Child Adolesc Psychiatry 2001; 40: 450-5. [DOI via Crossref]    [Pubmed]   
22. Giles LL, DelBello MP, Stanford KE, Strakowski SM. Child behavior checklist profiles of children and adolescents with and at high risk for developing bipolar disorder. Child Psychiatry Hum Dev 2007; 38: 47-55. [DOI via Crossref]    [Pubmed]   
23. Holtmann M, Bölte S, Goth K, Döpfner M, PlĂĽck J, Huss M, Fegert JM, Lehmkuhl G, Schmeck K, Poustka F. Prevalence of the Child Behavior Checklist- pediatric bipolar disorder phenotype in a German general population sample. Bipolar Disord 2007; 9: 895-900. [DOI via Crossref]    [Pubmed]   
24. Volk HE, Todd RD. Does the Child Behavior Checklist juvenile bipolar disorder phenotype identify bipolar disorder? Biol Psychiatry 2007; 62: 115-120. [DOI via Crossref]    [Pubmed]   
25. Papolos D, Hennen J, Cockerham MS, Lachman H. A strategy for identifying phenotypic subtypes: concordance of symptom dimensions between sibling pairs who met screening criteria for a genetic linkage study of childhood-onset bipolar disorder using the Child Bipolar Questionnaire. J Affect Disord 2007; 99: 27-36. [DOI via Crossref]    [Pubmed]   
26. Biederman J, Petty CR, Monuteaux MC, Evans M, Parcell T, Faraone SV, Wozniak J. The Child Behavior Checklist-Pediatric Bipolar Disorder profile predicts a subsequent diagnosis of bipolar disorder and associated impairments in ADHD youth growing up: a longitudinal analysis. J Clin Psychiatry 2009; 70: 732-40. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
27. Diler RS, Birmaher B, Axelson D, Goldstein B, Gill M, Strober M, Kolko DJ, Goldstein TR, Hunt J, Yang M, Ryan ND, Iyengar S, Dahl RE, Dorn LD, Keller MB. The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder. J Child Adolesc Psychopharmacol 2009; 19: 23-30. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
28. Biederman J, Mick E, Faraone SV, Spencer T, Wilens TE, Wozniak J. Pediatric mania: a developmental subtype of bipolar disorder? Biol Psychiatry 2000; 48: 458-466. [DOI via Crossref]   
29. Leibenluft E, Charney DS, Towbin KE, Bhangoo RK, Pine DS. Defining clinical phenotypes of juvenile mania. Am J Psychiatry 2003; 160: 430-437. [DOI via Crossref]    [Pubmed]   
30. Geller B, Zimerman B, Williams M, Delbello MP, Frazier J, Beringer L. Phenomenology of prepubertal and early adolescent bipolar disorder: Examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol 2002; 12: 3-9. [DOI via Crossref]    [Pubmed]   
31. Geller B, Zimerman B, Williams M, Delbello MP, Bolhofner K, Craney JL, Frazier J, Beringer L, Nickelsburg MJ. DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol 2002; 12: 11-25. [DOI via Crossref]    [Pubmed]   
32. Hunt J, Birmaher B, Leonard H, Strober M, Axelson D, Ryan N, Yang M, Gill M, Dyl J, Esposito-Smythers C, Swenson L, Goldstein B, Goldstein T, Stout R, Keller M. Irritability without elation in a large bipolar youth sample: frequency and clinical description. J Am Acad Child Adolesc Psychiatry 2009; 48: 730-9. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
33. Masi G, Perugi G, Toni C, Millepiedi S, Mucci M, Bertini N, Akiskal HS. The Clinical Phenotypes of Juvenile Bipolar Disorder:Toward a Validation of the Episodic-Chronic-Distinction. Biol Psychiatry 2006; 59: 603-610. [DOI via Crossref]    [Pubmed]   
34. Wozniak J, Biederman J, Kwon A, Mick E, Faraone S, Orlovsky K, Schnare L, Cargol C, van Grondelle A. How Cardinal are Cardinal Symptoms in Pediatric Bipolar Disorder? An Examination of Clinical Correlates. Biol Psychiatry 2005; 58: 583-588. [DOI via Crossref]    [Pubmed]   
35. Emiroglu FN, Diler RS. Pediatric bipolar disorders: from the perspective of Turkey. J Can Acad Child Adolesc Psychiatry 2009; 18: 206-14. [Pubmed]    [PMC Free Fulltext]   
36. Birmaher B, Axelson D, Strober M, Gill MK, Valeri S, Chiappetta L, Ryan N, Leonard H, Hunt J, Iyengar S, Keller M. Clinical course of children and adolescents with bipolar spectrum disorders. Arch Gen Psychiatry 2006; 63: 175-83. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
37. Maniscalco ER, Hamrin V. Assessment and diagnostic issues in pediatric bipolar disorder. Arch Psychiatr Nurs 2008; 22: 344-55. [DOI via Crossref]    [Pubmed]   
38. Rich BA, Schmajuk M, Perez-Edgar KE, Fox NA, Pine DS, Leibenluft E. Different psychophysiological and behavioral responses elicited by frustration in pediatric bipolar disorder and severe mood dysregulation. Am J Psychiatry 2007; 164: 309-317. [DOI via Crossref]    [Pubmed]   
39. Brotman MA, Schmajuk M, Rich BA, Dickstein DP, Guyer AE, Costello EJ, Egger HL, Angold A, Pine DS, Leibenluft E. Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry 2006; 60: 991-7. [DOI via Crossref]    [Pubmed]   
40. Brotman MA, Kassem L, Reising MM, Guyer AE, Dickstein DP, Rich BA, Towbin KE, Pine DS, McMahon FJ, Leibenluft E. Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation. Am J Psychiatry 2007; 164: 1140-2. [DOI via Crossref]    [Pubmed]   
41. Olfson M, Crystal S, Gerhard T, Huang CS, Carlson GA. Mental health treatment received by youths in the year before and after a new diagnosis of bipolar disorder. Psychiatr Serv 2009; 60: 1098-106. [DOI via Crossref]    [Pubmed]   
42. Bhargava Raman RP, Sheshadri SP, Janardhan Reddy YC, Girimaji SC, Srinath S, Raghunandan VN. Is bipolar II disorder misdiagnosed as major depression disorder in children? J Affect Disord 2007; 98: 263-266. [DOI via Crossref]    [Pubmed]   
43. Baumer FM, Howe M, Gallelli K, Simeonova DI, Hallmayer J, Chang KD. A pilot study of antidepressant-induced mania in pediatric bipolar disorder: Characteristics, risk factors, and the serotonin transporter gene. Biol Psychiatry 2006; 60: 1005-12. [DOI via Crossref]    [Pubmed]   
44. Chang KD, Saxena K, Howe M, SimeonovaD. Psychotropic medication exposure and age at onset of bipolar disorder in offspring of parents with bipolar disorder. J Child Adolesc Psychopharmacol 2010; 20: 25-32. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
45. Evans-Lacko SE, Zeber JE, Gonzalez JM, Olvera RL. Medical comorbidity among youth diagnosed with bipolar disorder in the United States. J Clin Psychiatry 2009; 70: 1461-6. [DOI via Crossref]    [Pubmed]   
46. Geller B, Fox LW, Clark KA. Rate and predictors of prepubertal bipolarity during follow-up of 6- to 12-year-old depressed children. J Am Acad Child Adolesc Psychiatry 1994; 33: 461-8. [DOI via Crossref]    [Pubmed]   
47. Masi G, Perugi G, Millepiedi S, Mucci M, Toni C, Bertini N, Pfanner C, Berloffa S, Pari C. Developmental differences according to age at onset in juvenile bipolar disorder. J Child Adolesc Psychopharmacol 2006; 16: 679-85. [DOI via Crossref]    [Pubmed]   
48. Biederman J, Faraone S, Mick E, Wozniak J, Chen L, Ouellette C, Marrs A, Moore P, Garcia J, Mennin D, Lelon E. Attentiondeficit hyperactivity disorder and juvenile mania: an overlooked comorbidity? J Am Acad Child Adolesc Psychiatry 1996; 35: 997-1008. [DOI via Crossref]    [Pubmed]   
49. Hazell PL, Carr V, Lewin TJ, Sly K. Manic symptoms in young males with ADHD predict functioning but not diagnosis after 6 years. J Am Acad Child Adolesc Psychiatry 2003; 42: 552-560. [DOI via Crossref]    [Pubmed]   
50. Spencer T, Biederman J, Wozniak J, Wilens T. Attention deficit hyperactivity disorder and affective disorders in childhood: continuum, comorbidity or confusion. Curr OpinPsychiatry 2000; 13: 73-79. [DOI via Crossref]   
51. Diler RS, Uguz S, Seydaoglu G, Erol N, AvcĂ˝ A. Differentiating bipolar disorder in Turkish prepubertal children with attentiondeficit hyperactivity disorder. Bipolar Disord 2007; 9: 243-51. [DOI via Crossref]    [Pubmed]   
52. Lus G, Mukaddes NM. Co-morbidity of bipolar disorder in children and adolescents with attention deficit/hyperactivity disorder (ADHD) in an outpatient Turkish sample. World J Biol Psychiatry 2009; 10: 488-94. [DOI via Crossref]    [Pubmed]   
53. Kozloff N, Cheung AH, Schaffer A, Cairney J, Dewa CS, Veldhuizen S, Kurdyak P, Levitt AJ. Bipolar disorder among adolescents and young adults: Results from an epidemiological sample. J Affect Disord 2010; 10.
54. Wilens TE, Biederman J, Adamson JJ, Henin A, Sgambati S, Gignac M, Sawtelle R, Santry A, Monuteaux MC. Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: a controlled study. Drug Alcohol Depend 2008; 95: 188-98. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
55. Esposito-Smythers C, Goldstein T, Birmaher B, Goldstein B, Hunt J, Ryan N, Axelson D, Strober M, Gill MK, Hanley A, Keller M. Clinical and psychosocial correlates of non-suicidal self-injury within a sample of children and adolescents with bipolar disorder. J Affect Disord 2010; 125:89-97. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
56. Goldstein TR, Birmaher B, Axelson D, Goldstein BI, Gill MK, Esposito-Smythers C, Ryan ND, Strober MA, Hunt J, Keller M. Family environment and suicidal ideation among bipolar youth. Arch Suicide Res 2009; 13: 378-88. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
57. Werry JS, McClellan JM, Chard L. Childhood and adolescent schizophrenic, bipolar, and schizoaffective disorders: a clinical and outcome study. J Am Acad Child Adolesc Psychiatry 1991; 30: 457-65. [DOI via Crossref]    [Pubmed]   
58. Cohen D, GuilĂ© JM, Brunelle J, Bodeau N, LouĂ«t E, Lucanto R, Consoli A. Bipolar episodes in adolescents: diagnostic issues and follow-up in adulthood. Encephale 2009; 35 (Suppl 6): 224-30. [DOI via Crossref]   
59. Correll CU, Penzner JB, Frederickson AM, Richter JJ, Auther AM, Smith CW, Kane JM, Cornblatt BA. Differentiation in the preonset phases of schizophrenia and mood disorders: evidence in support of a bipolar mania prodrome. Schizophr Bull 2007; 33: 703-14. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
60. Erkýran M, Karamustafalýoðlu N, Tomtuk N ve Kahraman E, Alpay N. Ergen ve Eriþkin Baþlangýçlý Maninin Fenomenolojik Farklýlýklarý: Karþýlaþtýrmalý Bir Çalýþma . Türk Psikiyatri Dergisi 2003; 14:21-30.
61. Carlson GA. Child and adolescent mania-diagnostic considerations. J Child Psychol Psychiatry 1990; 31: 331-341. [DOI via Crossref]    [Pubmed]   
62. Krasa NR, Tolbert HA. Adolescent bipolar disorder: a nine-year experience. J Affect Disord 1994; 30: 175-184. [DOI via Crossref]   
63. Carlson GA, Bromet EJ, Sievers S. Phenomenology and outcome of subjects with early- and adult-onset psychotic mania. Am J Psychiatry 2000; 157: 213-9. [DOI via Crossref]    [Pubmed]   
64. Birmaher B, Axelson D, Goldstein B, Strober M, Gill MK, Hunt J, Houck P, Ha W, Iyengar S, Kim E, Yen S, Hower H, EspositoSmythers C, Goldstein T, Ryan N, Keller M. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the Course and Outcome of Bipolar Youth (COBY) study. Am J Psychiatry 2009; 166: 795-804. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
65. Geller B, Tillman R, Bolhofner K, Zimerman B. Child bipolar I disorder: prospective continuity with adult bipolar I disorder; characteristics of second and third episodes; predictors of 8-year outcome. Arch Gen Psychiatry 2008; 65: 1125-33. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
66. Duffy A, Alda M, Hajek T, Grof P. Early course of bipolar disorder in high-risk offspring: prospective study. Br J Psychiatry 2009; 195: 457-8. [DOI via Crossref]    [Pubmed]   
67. Boylan KR, Bieling PJ, Marriott M, Begin H, Young LT, MacQueen GM. Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder. J Clin Psychiatry 2004; 65: 1106-13. [DOI via Crossref]    [Pubmed]   
68. Tamam L, Ozpoyraz N. Comorbidity of anxiety disorder among patients with bipolar I disorder in remission. Psychopathology 2002; 35: 203-9. [DOI via Crossref]   
69. Altindag A, Yanik M, Nebioglu M. The comorbidity of anxiety disorders in bipolar I patients: prevalence and clinical correlates. Isr J Psychiatry Relat Sci 2006; 43: 10-5. [Pubmed]   
70. Freeman AJ, Youngstrom EA, Michalak E, et al. Quality of life in pediatric bipolar disorder. Pediatrics 2009; 123: 446-52. [DOI via Crossref]    [Pubmed]   
71. Geller B, Tillman R, Craney JL, Bolhofner K. Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. Arch Gen Psychiatry 2004; 61: 459-467. [DOI via Crossref]    [Pubmed]   
72. Coryell W, Solomon D, Turvey C, Keller M, Leon AC, Endicott J, Schettler P, Judd L, Mueller T. The long-term course of rapidcycling bipolar disorder. Arch Gen Psychiatry 2003; 60: 914-920. [DOI via Crossref]    [Pubmed]   
73. Keck PE Jr, Versiani M, Potkin S, West SA, Giller E, Ice K. Ziprasidone in the treatment of acute bipolar mania: a threeweek, placebo-controlled, double-blind, randomized trial. Am J Psychiatry 2003; 160: 741-748. [DOI via Crossref]   
74. Tohen M, Jacobs TG, Grundy SL, McElroy SL, Banov MC, Janicak PG, Sanger T, Risser R, Zhang F, Toma V, Francis J, Tollefson GD, Breier A. Efficacy of olanzapine in acute bipolar mania: a doubleblind, placebo-controlled study. The Olanzipine HGGW Study Group. Arch Gen Psychiatry 2000; 57: 841-849. [DOI via Crossref]    [Pubmed]   
75. Pavuluri MN, Henry DB, Moss M, Mohammed T, Carbray JA, Sweeney JA. Effectiveness of lamotrigine in maintaining symptom control in pediatric bipolar disorder. J Child Adolesc Psychopharmacol 2009; 19: 75-82. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
76. Cascade E, Kalali A, Findling R. Use of antipsychotics in children. Psychiatry (Edgmont) 2009; 6: 21-3.
77. Haas M, Delbello MP, Pandina G, Kushner S, Van Hove I, Augustyns I, Quiroz J, Kusumakar V. Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study. Bipolar Disord 2009; 11: 687-700. [DOI via Crossref]    [Pubmed]   

How to Cite this Article
Pubmed Style

Ayfer Orhan, Osman Abalý. [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. PBS. 2011; 1(3): 126-135. Turkish. doi:10.5455/jmood.20110906023427


Web Style

Ayfer Orhan, Osman Abalý. [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. http://www.pbsciences.org/?mno=12082 [Access: September 29, 2021]. Turkish. doi:10.5455/jmood.20110906023427


AMA (American Medical Association) Style

Ayfer Orhan, Osman Abalý. [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. PBS. 2011; 1(3): 126-135. Turkish. doi:10.5455/jmood.20110906023427



Vancouver/ICMJE Style

Ayfer Orhan, Osman Abalý. [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. PBS. (2011), [cited September 29, 2021]; 1(3): 126-135. Turkish. doi:10.5455/jmood.20110906023427



Harvard Style

Ayfer Orhan, Osman Abalý (2011) [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. PBS, 1 (3), 126-135. Turkish. doi:10.5455/jmood.20110906023427



Turabian Style

Ayfer Orhan, Osman Abalý. 2011. [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. Psychiatry and Behavioral Sciences, 1 (3), 126-135. Turkish. doi:10.5455/jmood.20110906023427



Chicago Style

Ayfer Orhan, Osman Abalý. "[Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]." Psychiatry and Behavioral Sciences 1 (2011), 126-135. Turkish. doi:10.5455/jmood.20110906023427



MLA (The Modern Language Association) Style

Ayfer Orhan, Osman Abalý. "[Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]." Psychiatry and Behavioral Sciences 1.3 (2011), 126-135. Print.Turkish. doi:10.5455/jmood.20110906023427



APA (American Psychological Association) Style

Ayfer Orhan, Osman Abalý (2011) [Bipolar disorder from childhood to adolescence: A review about diagnostic difficulties and comorbidities]. Psychiatry and Behavioral Sciences, 1 (3), 126-135. Turkish. doi:10.5455/jmood.20110906023427