Pediatric and Early Adolescent Bipolar Disorder

Symptom Checklist

NAME: DATE:

M F D.O.B.: AGE:

RECORDING OBSERVER: _

NOTE:
This instrument focuses on the cardinal symptoms for Pediatric and Early Adolescence Bipolar Disorder, identified in the literature. Since some of the symptom categories, like precocious sexuality, morbid nightmares, and even decreased need for sleep have a lower prevalence rate, it has been difficult to establish a model for scoring. Thus, use it in combination with the FIND criteria below to ascertain the degree of dysfunction.

If you use this instrument, in addition please also

1.Rule out biomedical issues (lower gut problems, brain injuries, thyroid problems, serious early childhood viral infections aka PANDAS)

2.Establish pattern of age of onset, persistence, frequency and severity.

3.Establish adequate psycho-social history (family history of behavioral problems and/or mood disorders, substance abuse, and current family functioning, as well as past traumas).

  1. Presence of at least four of the five central criteria for PEA-BD

a)Episodes of excessively silly and childish elation (usually out of context).

b)Irritability or neurological meltdowns or tempertantrums (sudden and extreme emotional responses to unexpected stimuli).

c)Delusionality (regarding self, the rules, and misreading social interactions, may include morbid dreams, and confabulations).

d)Racing thought/pressured speech and flight of ideas.

e)Manic, impulsive behavior (may include decreased need for sleep).

  1. Use the FIND criteria for measuring the severity of symptoms (ACAP March 2005)
  2. Frequency- the symptoms are seen most days of the week
  3. Intensity- the symptoms cause severe disturbance in one or moderate disturbance in two domains of functioning
  4. Number- there are three or four behavioral symptoms
  5. Duration- the symptoms are visible for four hours a day though not necessarily contiguous

Rating method:

Enter age at onset and resolution in the Age of Onset column. For Frequency or Severity, mark a numeric value using the scale below:

0:Not at all

1:Rarely or somewhat true

2:Sometimes or moderately true

3:Often or mostly true

4:Always or very true

© Hanno Kirk, 2016

Patient name: M/F / DOB: / / / Today’s Date: / /
Symptoms and Behaviors / Age of onset-> when resolved / Circle response (see scoring key below)
  1. Infancy Behaviors
  2. Easily startled
  3. Difficult to console-“colicky”
/ 0 1 2 3 4
0 1 2 3 4
  1. Decreased need for sleep
  2. Inability to go to sleep- yet still wakes up early
  3. “Light bulb” phenomenon-very awake, then suddenly falls asleep (“out like a light”)
/ 0 1 2 3 4
0 1 2 3 4
  1. Precocious early development (record if earlier than normal)
  2. Fine and gross motor skills
  3. Cognitive and language
  4. Complex thought patterns
  5. Creativity (writing, music, art, etc)
  6. Developmentally delayed
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Early morning grouchiness
  2. Resistance to following directions, oppositional
  3. Fuzzy, confused thinking
/ 0 1 2 3 4
0 1 2 3 4
  1. Recurring nightmares or night terrors (with delusional quality of being real even after waking
  2. Themes of death and harm
  3. ->Morbid fascination with or brooding about death
  4. Fear of harm befalling parents
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Sensory integration dysfunction- sensitive to:
  2. Temperature (too hot or cold)
  3. Touch, texture
  4. Light
  5. Auditory
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Regression behaviors under stress
  2. Clinging behavior
  3. Thumb-sucking, needing security blanket or toy animal
  4. Disorganized thinking, speech, odd body positions
  5. Becoming anxious
  6. Withdrawal, non-verbal episodes
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Separation anxiety
  2. Needs parent present
  3. Upset or anxious when parent leaves or goes out of sight
/ 0 1 2 3 4
0 1 2 3 4
  1. School phobia
  2. Resistance to going to school
  3. Complaints of physical symptoms (head, stomach aches, nausea)
  4. Anxious or panicky about going or being in school
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Precocious interest in sex
  2. Touching, pleasuring self
  3. Masturbation
  4. Exploring, touching others
  5. Initiating sexual activities
  6. Predatory sexual activities
  7. Using adult language
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Resistance to rules
  2. Insists that rules don’t apply to him/her
  3. Insists that he/she should make the rules (grandiosity)
  4. Becomes argumentative
  5. Becomes irrational
  6. Uses abusive, foul language
  7. Rage or tantrum if rules enforced
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Narcissistic attitudes and behaviors
  2. Blaming others for arguments and fights
  3. Poor self reporting (doesn’t see/admit to shortcomings)
/ 0 1 2 3 4
0 1 2 3 4
  1. “Lying”
  2. To avoid blame
  3. No memory of rage/tantrum (anterograde amnesia)
  4. Dissociates or blanks out during stress/trauma
  5. Confabulation (making up fantastic stories, lies)
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Grandiosity
  2. Obsessive compulsive like persistence to grandiose ideas or plans
  3. Delusional quality to ideas or roles
/ 0 1 2 3 4
0 1 2 3 4
  1. Risk taking
  2. With themes of self harm, death
  3. Seemingly irrational dangerous acts
  4. Deliberate self harming behaviors
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Elation<->Irritability
Elation
  1. With hyper (manic) energy
  2. Exaggerated and out of context
  3. Excessive talking, excessive childish silliness
  4. Alternating rapidly with irritability
Irritability
  1. Grouchy and depressed
  2. Temper tantrums/rages lasting more than 45 min
  3. Destructive episodes with cruel or sadistic intent
  4. Fighting
  5. Bullying
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Depressed mood
  2. Barely able to function (signs of depression-tired, decreased appetite, low energy, no pleasure)
  3. Signs of fuzzy confused thinking
  4. Expresses feeling of worthlessness
  5. Thoughts of suicide
  6. Suicide attempts
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Flight of ideas
  2. Pressured or accelerated speech
  3. Jumping from idea to idea
  4. Incomplete sentences
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Obsessive compulsive like fixations (rigid or inflexible)
  2. Polarized thinking-has to be either/or
  3. Wanting things done the same way
  4. Single minded pursuit of wants (want it NOW)
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Impulsivity (often with deliberate intent)
  2. Impulsive, unexpected behaviors
  3. Impulsive speech (socially inappropriate)
  4. Poor judgment due to delusional grandiosity
/ 0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
  1. Distractibility (high energy)
  2. Rapid shifts of interest during hypo or hypermania
  3. Restless and fidgety
/ 0 1 2 3 4
0 1 2 3 4

Comments or examples of problems noted above:

C 2016

0=not at all, 1=rarely or somewhat true, 2=sometimes or moderately true,

3=often or mostly true, 4=always or very true