Irritability and Elation: The Consequences of Thinking about Pediatric Bipolar Disorder and Sever Mood Dysregulation

Irritability and Elation:
The Consequences of Thinking about Pediatric Bipolar Disorder and Sever Mood Dysregulation

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Irritability and Elation: The Consequences of Thinking about Pediatric Bipolar Disorder and Sever Mood Dysregulation ~ Member Rate - $25.00

Irritability and Elation: The Consequences of Thinking about Pediatric Bipolar Disorder and Sever Mood Dysregulation - $30.00

Session Summary

Severe mood dysregulation (SMD) is a relatively common childhood syndrome characterized by three features: chronic anger and irritability, recurrent explosive outbursts, and the non-specific hyperarousal symptoms from the “B criteria” for mania including insomnia, agitation, distractibility, pressured speech, racing thoughts, and intrusiveness. Initially, SMD was proposed as an attempt to operationalize a definition of the “broad phenotype” of pediatric bipolar disorder (BD). In an effort to test the assumption that SMD is a developmental form of BD, we examined the clinical course, family history, and neurobiology of individuals with SMD and compared them to pediatric patients with strictly defined DSM-IV BD. Current evidence to guide the pharmacologic treatment of SMD is extremely limited. Patients with SMD may benefit from targeting symptoms or features such as depression, anxiety, and attention-deficit/hyperactivity disorder, but more research is needed on pharmacologic and psychotherapeutic approaches to treatment.

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Faculty Information

Kenneth Towbin, MD

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Kenneth Towbin, MD
Clinical Professor, George Washington University School of Medicine
Chief of Clinical Child and Adolescent Psychiatry-Emotion and Development Branch
Intramural Research Program
NIMH
Washington DC

Kenneth E. Towbin, M.D., is a Clinical Professor of Psychiatry and Behavioral Science at the George Washington University School of Medicine. His current work is as Chief of Clinical Child and Adolescent Psychiatry in the Emotion and Development Branch at the Intramural Research Program at NIMH where he has worked for nearly 10 years.

Dr. Towbin has extensive and diverse experience in child and adolescent psychiatry.‪ He has authored on the diagnosis and treatment of Tourette Syndrome, Obsessive-Compulsive Disorder, and Autism Spectrum Disorders. His current research interests are in emotion and the development of mood disorders including the phenomenology and treatment of pediatric-onset Bipolar Disorder, Severe Mood Dysregulation in childhood, and pediatric Anxiety Disorders. He is a past member of the Editorial Board of the Journal of the American Academy of Child and Adolescent Psychiatry. He also is currently a member of the Pediatric Advisory Committee of the Food and Drug Administration.

Dr. Towbin is a Diplomat of the American Board of Psychiatry and Neurology, in both General Psychiatry and in Child and Adolescent Psychiatry.

Presentation will include discussion of off-label, experimental, and/or investigational use of drugs or devices:

Since Severe Mood Dysregulation is not a DSM diagnosis; there are no medications that have FDA approval for this constellation of symptoms. Thus, discussion of treatment with any class or specific agent will necessarily be ?off-label? including stimulants, lithium, divaloproex, second generation or atypical antipsychotics, and serotonin reuptake inhibitors. Divalproex for children and adolescents with bipolar disorder is also not FDA approved nor is lithium for children under 12.

Learning Objectives

Recognize the clinical manifestations of Pediatric Bipolar Disorder (BPD) & Severe Mood Dysregulation (SMD).
Outline the evidence for considering SMD and BPD as separate entities: course, family history, and pathophysiology.
Describe treatment considerations, including pharmacological approaches, for patients with BPD & SMD.

Continuing Education Credit

Activity Dates: 05/03/2011 - 05/03/2014
ACPE Contact Hours: 1.0
ACPE Number: 0284-9999-11-014-H04-P (Knowledge)
Nursing Credit Reminder: Note that ACPE and ACCME credit is accepted for certification renewal.

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ACPE The College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This self-study course provides 1.0 contact hours (0.10 CEUs) of knowledge-based continuing education credit from CPNP approved programming. The ACPE universal program number assigned to this course is 0284-0999-11-014-H04-P (1.0 contact hours).

ACPE approved contact hours are accepted for ANCC Certification Renewal (see pages 5 and 6): At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:

Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
Continuing medical education (CME) approved for CME hours
Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration

Course Requirements

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

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Minimum:

Internet Explorer 6+, Firefox 2+ or Safari 3+
1024x768 resolution or greater
Adobe Flash Player 8+
512MB RAM
Any Operating System capable of the above requirements

Recommended:

Internet Explorer 7+, Firefox 3+ or Safari 3+
1280x768 resolution or greater
Adobe Flash Player 10+
Windows XP/2000/Vista and Mac OS 10.4 or better
512MB of RAM for Windows XP or Mac OS
1GB of RAM for Windows Vista

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the medication therapy management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Grant Support

This programming was supported in part by grants from Bristol-Myers Squibb, Cyberonics, Merk and Sunovion.