Pediatric bipolar disorder (PBD) is a growing public health problem in the United States, especially among adolescent children. Despite awareness of the diagnosis and the effects that it has on the child, little attention has been given to the effects that PBD has on the guardian. The purpose of this qualitative phenomenological study was to explore the factors influencing guardians' experiences related to PBD. Penchansky and Thomas' Theory of Access and Family Systems Theory were used in this study to explore guardians lived experiences of PBD, its effects on the entire family system, and mental health service treatment. This approach was composed through interviewing 6 guardians caring for adolescents diagnosed with PBD. Interviews were conducted, transcribed and coded using NVivo12 software. The findings revealed the emergent themes as follows: disbelief of initial diagnosis, coping mechanisms, advice, barriers, burdens, stressors, and challenges. The themes described the experiences of guardians that led to feelings of denial, frustration, embarrassment, and resentment. Damaged relationships, medical problems, and financial hardships are only some of the challenges that guardians expressed during the interview. The issues that the guardians experienced provide evidence to fill the gap in the literature regarding effects on guardians. Further research into mental health services and guardians' perceptions on PBD is needed. This study promotes social change by informing mental health providers of the feelings and stressors of the guardians of PBD patients, which may lead to improved care for the family unit.

Bipolar disorder (BD) is a chronic, progressive illness characterized by fluctuations in mood. It is associated with psychosocial and cognitive impairment that can affect a person’s life at home, at work or school, and in interpersonal relationships. Children and adolescents diagnosed with BD experience similar functional impairments and risk for suicidal thoughts or actions compared to adults. Additionally, they are at an increased risk for poorer prognosis during adulthood given the negative outcomes associated with early illness onset, delayed treatment, misdiagnosis, and longer illness duration. The etiology and pathophysiology of bipolar disorder is incompletely understood. Peripheral blood biomarkers can provide insight into the mechanisms underlying the disease and can aid in identifying at-risk individuals, making an accurate diagnosis, monitoring illness activity and improving therapeutic intervention. A PubMed search was carried out and 12 studies were identified that assessed potential peripheral blood biomarkers in children and adolescents with bipolar disorder. These studies suggest that fatty acid biostatus, markers of lipid and protein oxidation, markers of inflammation and immune disturbance, neurotrophic factors and enzymes related to inflammation may serve as biomarkers of BD. These potential biomarkers of the disorder warrant further study in youth with BD. Current findings support a staging hypothesis of BD wherein cumulative episodes lead to disruptions of the pathways associated with the disorder and thus greater impairment in patients farther from their disease onset. However, these and other biomarkers will need to be evaluated in larger, longitudinal studies to validate their use and expand knowledge in the field.

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The purpose of this study was to understand the effects of pediatric bipolar disorder on child siblings. A quantitative quasi-experimental research design was used. According to family systems theory, which was used in the formation of this study, all family members are interconnected and affect each other in a variety of ways. The research questions investigated whether children demonstrated more emotional dysregulation and fewer adaptive skills when a bipolar sibling was living in the home than when there was no bipolar sibling. The matched comparison study used 2 groups of children: those with bipolar siblings and those without bipolar siblings. Parents completed the BASC-2 Parent Rating Scale in order to measure adaptive skills and emotional dysregulation in their non-bipolar children. Parents were recruited via social media parent support sites. Thirty-four families included in the study group had 1 bipolar child and at least 1 nonbipolar child living in the home; 31 families in the comparison group had no bipolar children. All children were under the age of 18, living together full time, had a biological or legal relationship, and did not have any other mental health diagnosis. A multivariate analysis of variance was used to test the hypotheses. The study found that children with bipolar siblings demonstrated significantly higher levels of emotional dysregulation (both externalization and internalization) than did children without bipolar siblings. There was no significant difference in reported adaptive skills between the 2 groups of children. This study has social change implications as it identifies the emotional needs of sibling children who are routinely overlooked as needing assistance. This study provides the groundwork for clinicians and educators working in the pediatric mental health field to begin exploring potential treatments and programs for siblings of bipolar children.