The Concept of Bipolar Disorder in Children: A History of the Bipolar Controversy

Before the last 150 years, the use of the term mania to mean any kind of agitated state and the term childhood to include people up to their early 20s make historical identification of manic-depression in children difficult. Not long after Kraepelin's seminal work was published, similar syndromes were identified in youth, usually adolescents. Interestingly, however, the question of whether preadolescent mania should be broadly or narrowly defined–the so-called bipolar controversy–has been an issue for at least 50 years. Although the question of whether and how a disorder characterized by discrete episodes of mania and depression with periods of relative normality between episodes relates to one characterized by more fluctuating and intense mood lability/dysregulation remains unanswered, the work of researchers in the twenty-first century will be to understand not only symptoms of bipolar disorder but also how it develops and how emotion regulation relates to both the development of bipolar disorder and to other conditions that are characterized by dysregulated emotion.