Zeineb Abbes, Tunisia
Razi Hospital Child and adolescent psychiatryAuthor Of 1 Presentation
Clinical features of bipolar disorder in adolescents with intellectual disability - EPV0208
Abstract
Introduction
Bipolar disorder in children and adolescents is distinguished by a variable and complex clinical expression. Mood symptoms are often masked and signs of disorganization may be in the limelight. This becomes more difficult when adolescents have intellectual disability.
Objectives
This work aims to describe diagnostical and therapeutical features of bipolar disorder in adolescents with intellectual disability.
Methods
Case reports about five patients who have been diagnosed with bipolar disorder associated to intellectual disability, all seen and treated in child and adolescent psychiatry department of Razi Hospital, in Tunis.
Results
The study focused on three girls and two boys, all with mild to moderate intellectual disability. Four patients had psychiatric family history of bipolar disorder and intellectual disability. Only one patient was followed since childhood for mixed ADHD. The average age of onset of bipolar disorder was 14 years. Four cases were inaugurated by manic access; the fifth was a depressive disorder followed by a manic shift under sertraline. Only one case was rapidly favorable, under 10mg of Olanzapine, without any recurrence or relapse during 18 months of follow-up. Another case was slower but also favorable, under 10mg of Olanzapine. We found resistance to usual treatments for 2 patients; these didnt evolve well neither under conventional thymoregulators, nor different antipsychotics, nor with combinations of 2 thymoregulators + antipsychotic. One of them benefited from a combination of clozapine and lithium with excellent response.
Conclusions
Clinical features of bipolar disorder in adolescents with intellectual disability deserve to be mastered by the practitioner for an optimal care of these difficult cases.