Manic-depressive conditions in adolescents. Epidemiological and clinical aspects

EPIDEMIOLOGY CONTEXT: The prevalence of maniac depressive disorders is similar in adolescents and adults, i.e. about 1% with a 1:1 sex-ratio. Risk is higher in families with a diseased member and early episodes of mood disorders are probably correlated with the genotypic severity or the presence of a unique susceptibility gene. HIGHLY VARIABLE CLINICAL SIGNS: Until recent years, the highly variable clinical expression with rapid changes in mood, bipolar states, variable somatic, behavioral or addictive symptomatology, cognition disorders, and disturbed ideation or hallucinations, probably contributed to our poor understanding of juvenile forms of the disease. EARLY MANAGEMENT: Early diagnosis and psychiatric care is crucial due to the short-, mid- and long-term risk of unfavorable or even fatal consequences. Indeed, while still in the process of structuralization, the predisposed personality is particularly reactive to positive or negative events. It is most difficult to achieve flexibility once a restrictive organization of the personality has been installed. In addition, these families often have a painful past and lack sufficient capacity to successfully deal with the stress of emotions and conflicts occurring in the future adult during the self-identification and independence-seeking processes. This familial situation points out the importance of implicating the family and close friends in the treatment strategy as a complement to drug therapy and psychotherapy proposed to the adolescent.