1) Almost Bipolar: How to Identify Youth at Risk
There’s a new diagnostic concept in child psychiatry: The bipolar prodrome. It refers to children who are at risk for bipolar disorder but don’t have the full illness. Research in this area is gathering steam, and nearly all of it focuses on adolescents whose parent has bipolar disorder.
2) Treatment Options for Youths at Risk for Bipolar Disorder
Consider these take-home points:
• Proceed cautiously with antidepressants and stimulants in young patients with a strong family history of bipolar disorder
• Antidepressant-induced mania often presents as a mixed state, which feels to the patient like a worsening of their depression, so take seriously any signs of worsened mood on these agents
• If manic symptoms are present, attend to them with a mood stabilizer before starting treatments that can further destabilize mood
• Stabilize the environment as well, with family therapy, skill building, and regulation of sleep and circadian rhythms.
3) Psychiatry Update: Electronic Bullying, Mortality, Microbes
An extreme case of electronic stalking, the opioid crisis, gene mapping for depression, and other editors’ choices are featured on this webpage.
4) Responding to the Opioid Epidemic and Expanding Access to Quality Treatment
The US is facing the largest epidemic of opioid overdose deaths in its history. This CME addresses issues associated with the medication-assisted treatment protocol for opioid use disorder.
5) Depressive Symptoms Predict Future Pain, Disability in Adolescent JIA
Baseline depressive symptoms were associated with pain and disability in adolescents with juvenile idiopathic arthritis.