Complex and Rapid Cycling in Bipolar Children and Adolescents:
A Preliminary Study

by Barbara Geller, M.D.; Kai Sun, Ph.D.; Betsy Zimerman, M.A.; Joan Luby, M.D.; Jeanne Frazier, B.S.N.; Marlene Williams, R.N.

Twenty-six subjects aged 7-18 years old were studied. Diagnoses of bipolar disorders were established using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present Episode Version-1986 modified for DSM-III-R criteria and for rating the number and duration of manic and hypomanic episodes. Complex cycling patterns were observed. These included numerous, brief episodes suggesting continuous, rapid-cycling in 80.8% of cases. Mean age of onset was early (8.5±4.4 years). Psychotic phenomena, suicidality, hyperactivity, and "mixed mania" were highly prevalent. Data in this report provide support for complex and rapid-cycling patterns in childhood onset BP.