Faculty Collaboration Database

The naturalistic course of pharmacologic treatment of children with maniclike symptoms: a systematic chart review. J Clin Psychiatry 1998 Nov;59(11):628-37; quiz 638

Date

12/23/1998

Pubmed ID

9862614

DOI

10.4088/jcp.v59n1111

Scopus ID

2-s2.0-0031762565 (requires institutional sign-in at Scopus site)   95 Citations

Abstract

OBJECTIVE: To assess the effectiveness of mood stabilizers in treating maniclike symptoms in children.

METHOD: Subjects were consecutively referred pediatric patients who, at initial intake, satisfied DSM-III-R criteria for mania on a structured diagnostic interview. We systematically reviewed their clinical records to assess (1) the course of maniclike symptoms and (2) all medications prescribed at each follow-up visit. Survival analysis was used to determine the effect of mood stabilizers and other medications on the course of maniclike symptoms.

RESULTS: Of the 59 subjects meeting criteria for mania, 44 (75%) exhibited evidence of maniclike symptoms during follow-up. The occurrence of manic symptoms significantly predicted the subsequent prescription of mood stabilizers (rate ratio = 2.9, 95% confidence interval [CI] = 1.6 to 5.5), and use of mood stabilizers predicted decreases in manic symptoms (rate ratio = 4.9, 95% CI = 1.2 to 20.8). However, improvement was slow and associated with a substantial risk for relapse.

CONCLUSION: Mood stabilizers were frequently used in children with maniclike symptoms, and their use was associated with significant improvement of maniclike symptoms, whereas use of antidepressant, antipsychotic, and stimulant medications was not.

Author List

Biederman J, Mick E, Bostic JQ, Prince J, Daly J, Wilens TE, Spencer T, Garcia-Jetton J, Russell R, Wozniak J, Faraone SV

Author

Jennifer G. Jetton MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Antidepressive Agents, Tricyclic
Antipsychotic Agents
Bipolar Disorder
Carbamazepine
Central Nervous System Stimulants
Child
Clinical Protocols
Comorbidity
Dose-Response Relationship, Drug
Drug Administration Schedule
Follow-Up Studies
Humans
Lithium
Medical Records
Mental Disorders
Psychiatric Status Rating Scales
Recurrence
Retrospective Studies
Survival Analysis
Treatment Outcome
Valproic Acid