Hypersexuality in Children with Bipolar Disorder
Hypersexuality in children with mania: Little evidence of sexual abuse
Recent research by Barbara Geller, M.D. and colleagues in an ongoing NIMH-financed study at Washington University in St. Louis found that hypersexual behavior was present in 43% of the kids with mania although only 1% of her sample had evidence of sexual abuse. The study included 93 children with mania whose average age was 10.9 years.
The Balanced Mind Foundation receives reports of children being removed from their homes by social workers taught to assume that hypersexual behavior in a child is evidence of abuse. Based on Geller's important finding, it may be evidence of mania instead.
Many parents posting on the message boards on The Balanced Mind Foundation's Web site report this symptom in children as young as 2 or 3, and they report that with proper treatment with mood stabilizers, the mania (including the hypersexuality) often resolve completely.
Geller and colleagues found hypersexuality present in 30% of prepuberal children with mania, and in 60% of children with mania who had reached puberty.
Hypersexuality is not specific to mania, although it is a red flag for considering the presence of mania. It could also be a symptom of having been sexually abused, or having been exposed to an overstimulating environment, e.g., exposed to nude pictures, porn videos, or sexual activity in others. Kids with autism or retardation sometimes masturbate inappropriately, possibly as a form of more generic self stimulation or anxiety reduction. Self-stimulation can also occur with anatomical abnormalities; hormonal abnormalities; and urinary tract infections. Bizarre sexual symptoms may also occur in childhood schizophrenia.
Hypersexuality occurs more frequently in children with bipolar disorder who did not have sexual abuse histories than in children with ADHD, according to a study by Dr. Barbara Geller and colleagues in which the authors compared 93 kids with prepubertal mania to 81 kids with ADHD who did not have mania (and 94 controls). There were hypersexuality symptoms in 43% of the kids with mania but also in 6% of the kids with ADHD who did not have mania (Geller, et al, "Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality." Journal of Child and Adolescent Psychopharmacology 2002 Vol. 12(1): 3-9.)
Barbara Geller, M.D., Kristine Bolhofner, B.S., James L. Craney, M.P.H., Marlene Williams, R.N., Melissa DelBello, M.D., and Karl Gunderson, M.D., "Psychosocial Functioning in a Prepubertal and Early Adolescent Bipolar Disorder Phenotype," Journal of the American Academy of Child & Adolescent Psychiatry, 39:12, Dec. 2000.
Barbara Geller, M.D., Betsy Zimmerman, M.A., Marlene Williams, R.N., Kristine Bolhofner, B.S., James L. Craney, M.S., M.P.H., Melissa P. DelBello, M.D., and Cesar A. Soutullo, M.D., "Diagnostic Characteristics of 93 Cases of a Prepubertal and Early Adolescent Bipolar Disorder Phenotype by Gender, Puberty and Comorbid Attention Deficit Hyperactivity Disorder." Journal of Child and Adolescent Psychopharmacology. Vol. 10, No. 3, 2000 (pp. 157-164.)