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Nation’s First Child and Adolescent Inpatient Unit for Bipolar Disorders Opens at Western Psychiatric Institute & Clinic of UPMC

PITTSBURGH, Oct. 20, 2010 – The Western Psychiatric Institute and Clinic (WPIC) of UPMC has opened the nation’s only inpatient unit dedicated to serving children with bipolar disorder. The Inpatient Child and Adolescent Bipolar Services (in-CABS) is an innovative program aimed at facilitating early identification and treatment of bipolar disorder in children during their initial visit to WPIC’s emergency department.

Up to 15 percent of school-aged children seen at psychiatric facilities and approximately one-third of children discharged from psychiatric hospitals fit the diagnostic criteria for bipolar disorder. Symptoms of this chronic disease are mood swings that may include recurrent cycles of depression and mania, changes in levels of activity and functioning, inappropriate social behavior, hypersexuality, sleep and appetite changes, difficulty with concentration and racing thoughts.

Given the high morbidity and mortality associated with bipolar disorder, the common misdiagnosis as major depression, disruptive behavior disorders and ADHD, and the increased risk of suicide associated with incorrect treatment, it is critically important to distinguish bipolar disorder from other psychiatric conditions before the  disorder progresses,” said Rasim Somer Diler, M.D., medical director of in-CABS and assistant professor of psychiatry at the University of Pittsburgh. “With our novel, multi-layered approach, we will be better able to identify, diagnose and treat this extremely debilitating disorder.”

The in-CABS recently began screening all children under the age of 18 who are admitted to the WPIC emergency department for a bipolar diagnosis. All parents or caregivers of children who arrive at the emergency department complete a Child Mania Rating Scale, which is a tool that reviews both past and current manic symptoms when assessing for bipolar disorder. The scale also includes questions about family psychiatric history, the strongest predictor of bipolar disorder in children. The in-CABS team then does its own assessment to confirm the diagnosis.

“The in-CABS not only helps the children and their families to correctly identify bipolar disorder, but also helps them to rule out this possibility, which is very important when planning their treatment,” adds Dr. Diler. “During the inpatient stay, children and their families receive state-of-the art treatments that target their individual needs, including workbooks and psycho-education materials written by the in-CABS team; training for mood monitoring, sleep hygiene, daily routines, and healthy nutrition and exercise; as well as  dialectical, cognitive behavioral, yoga, music and art therapies.”

The Child and Adolescent Bipolar Services (CABS), an outpatient clinic at WPIC that is directed by Drs. Boris Birmaher and David Axelson, has served children with bipolar disorders regionally and nationally for more than a decade and is now coordinating efforts with the in-CABS program to connect bipolar youth with ongoing research studies that will in turn help the medical team to intervene before the full expression of bipolar disorder.

“The success of this program will inform the design of future, larger studies for conceptualization of this complicated and devastating psychiatric illness, as well as for improving our diagnostic assessment and quality of care,” adds Dr. Diler. “We hope in-CABS can serve as a model for other programs across the country.”

About the Western Psychiatric Institute and Clinic of UPMC

Western Psychiatric Institute and Clinic (WPIC) is considered to be one of the nation’s foremost university-based psychiatric care facilities and one of the world’s leading centers for research and treatment of mental health disorders. WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine and is the flagship of UPMC Behavioral Health, the psychiatric specialty division of the University of Pittsburgh Medical Center.

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