Manic symptoms in psychiatrically hospitalized children - what do they mean?

Objective: To examine the clinical implications of manic symptoms in psychi atrically hospitalized children aged 5-12. Methods: DSMIIIR manic symptoms, along with symptoms of other psychiatric disorders, were rated by parents and teachers on the Child Symptom Inventory IIIR prior to hospitalization. The Child Behavior Checklist (CBCL; was also completed. During hospitalizat ion children were evaluated by structured interview (K-SADS-E), and numerou s rating scales weekly. Children with symptoms of mania (mania criteria wit h/without episodes) were compared to those without mania. Severity of atten tion deficit hyperactivity disorder (ADHD), oppositional defiant disorder ( ODD), depression, CBCL factors, and comparable factors from teacher and par ent inpatient rating scales were examined. Finally, a subgroup of both grou ps of children treated with stimulants were compared at baseline and at lea st two weeks of treatment. Results: Children with manic symptoms had more s evere ADHD, ODD and depression symptoms. CBCL scores on aggression, social and thought problems were higher. Teachers and nursing staff made similar o bservations. Time in hospital was greater for children with manic symptoms. Both groups improved significantly on stimulant medication though reductio n in overall psychopathology was often modest. Conclusions: Manic symptoms, regardless of whether or not they represent bipolar disorder, are a marker of serious psychopathology and treatment resistance. (C) 1998 Elsevier Sci ence BN; All rights reserved.