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(PSYCHIATRIC TIMES) - by Gregory T. Lombardo, MD, PhD
New York: St. Martin's Press, 2006
384 pages • $24.95 (hardcover)

Childhood bipolar disorder is a devastating illness that affects emotional, social, and cognitive development. In recent years, increased attention devoted to the study of bipolar disorder in childhood has resulted in greater information regarding the cause, phenomenology, and treatment of the disorder. However, despite improved understanding and awareness, the diagnosis of bipolar disorder in children is still plagued by confusion and misunderstanding because of the complex and diverse presentations of the condition, difficulties in diagnosis, and overlap with other disorders.

The aim of Understanding the Mind of Your Bipolar Child is to provide a comprehensive overview of bipolar disorder in childhood, including diagnosis, developmental issues, common co-occurring disorders, and treatment options. What is most unique about this book, in comparison with others that discuss diagnostic issues and treatments, is that it focuses on considering bipolar disorder within a developmental framework, informed mostly by psychodynamic principles. The emphasis on development leaves the reader with a comprehensive and integrated notion of how symptoms of bipolar disorder interact dynamically with other personal characteristics and contextual variables of the child in affecting his or her developmental trajectory.

The book is divided into 3 parts: "Diagnosis," "Development," and "Treatment." Part I focuses on the complexities of diagnosing bipolar disorder in children. The author outlines clearly the types of symptoms that suggest a bipolar spectrum disorder and then discusses the different types of bipolar disorder. A strength of this section is the attention paid to the complications encountered when diagnosing bipolar disorder, including different sources of information, the varying spectrum of the disorder, the varying age at onset, and overlapping conditions.

Part II, the longest and most involved section, undertakes a comprehensive exploration of bipolar disorder within the developmental context of the individual child. This section is organized into the developmental periods of infancy, toddlerhood, school age, preadolescence, early adolescence, adolescence, and late adolescence. For each stage, the important developmental milestones that are optimally achieved are discussed, as well as crucial transitions that the child must negotiate during each stage.

The author impressively integrates information about normative development, individual differences, interpersonal relationships, and identity issues into a fluid and thoughtful account of the development of a bipolar spectrum illness over the course of childhood and adolescence. Concepts are illustrated using detailed case examples and formulations that help the reader integrate and consolidate the information presented. Part II concludes with a detailed explanation of disorders that commonly accompany bipolar disorder and how the co-occurrence may affect development, prognosis, and treatment.

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