Abstract
There has been a serious delay in recognizing early onset bipolar disorder (particularly childhood-onset) among psychiatrists in Japan, probably due to a possible problem of medical education and a lack of child psychiatrists. Although the same diagnostic criteria and subtypes of bipolar disorder are used for all ages of patients, clinical manifestation differs greatly between childhood and adult onset bipolar disorder. What makes the diagnosis of the disorder difficult in childhood may be such factors as behavioral rather than mood changes as main clinical manifestation, irregular and often rapid cycling of mood, a need for the assessment of how comorbid disorder(s), such as pervasive developmental disorder and AD/HD, influences clinical pictures, and a need to rule out medical conditions that cause mood symptoms (e.g. epilepsy, use of steroids). Finally, it is argued that, in order to improve the current situation regarding early onset bipolar disorder in Japan, the education of child psychiatry seems essential.
