Epidemiological and clinical aspects

Epidemiology context: The prevalence of maniac depressive disorders is simi lar in adolescents and adults, i.e about 1% with a 1:1 sex-ratio. Risk is h igher in families with a diseased member and early episodes of mood disorde rs are probably correlated with the genotypic severity or the presence of a unique susceptibility gene. Highly variable clinical signs: Until recent years, the highly variable cli nical expression with rapid changes in mood, bipolar states, variable somat ic, behavioral or addictive symptomatology, cognition disorders, and distur bed ideation or hallucinations, probably contributed to our poor understand ing of juvenile forms of the disease. Early management: Early diagnosis and psychiatric care is crucial due to th e short; mid- and long-term risk of unfavorable or even fatal consequences. Indeed, while still in the process of structuralization, the pre disposed personality is particularly reactive to positive or negative events. It is most difficult to achieve flexibility once a restrictive organization of th e personality has been installed. In addition, these families often have a painful past and lack sufficient capacity to successfully deal with the str ess of emotions and conflicts occurring in the future adult during the self -identification and independence-see- king processes. This familial situati on points out the importance of implicating the family and close friends in the treatment strategy as a complement to drug therapy and psychotherapy p roposed to the adolescent.