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Bipolar disorder in children and adolescents is difficult to diagnose and treat. A thorough evaluation is necessary to diagnose a child with bipolar disorder. It requires a detailed history of both mood and nonmood symptoms. A comprehensive face-to-face assessment of the child with and without the parents, including mental status examination, is necessary to rule out pervasive developmental disorders, language and thought disorders, and psychotic symptoms. Structured and semistructured interviews may be used to help assess mania in children (Weller et al. 1995). The diagnostic workup should be done in a systematic fashion. First, manic symptoms secondary to drug use or general medical conditions should be ruled out. Neurological conditions such as temporal lobe epilepsy, systemic lupus erythematosus, multiple sclerosis, Wilson's disease, closed- or open-head injury, and alcohol-related neurodevelopmental disorder can affect or mimic mood symptoms. Medications such as TCAs, SSRIs, corticosteroids, sympathomimetic amines, and aminophylline may increase mood cycling.

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