TABLE 6

Research Criteria for Broad Phenotype of Juvenile Mania: Severe Mood and Behavioral Dysregulation

A. Inclusion criteria
 a. Age 7–17 y, with onset of symptoms before age 12
 b. Abnormal mood present at least half of the day most days and of sufficient severity to be noticeable by people in the child’s environment
 c. Hyperarousal, as defined by at least 3 of the following symptoms: insomnia, agitation, distractibility, racing thoughts or flight of ideas, pressured speech, intrusiveness
 d. Compared with his/her peers, the child exhibits markedly increased reactivity to negative emotional stimuli that is manifest verbally or behaviorally
 e. The symptoms noted in the previous 3 items are currently present and have been present for at least 12 mo without any symptom-free periods exceeding 2 mo in duration
 f. The symptoms are severe in at least 1 setting and at least mild symptoms in a second setting
B. Exclusion criteria
 a. The individual exhibits any of the cardinal bipolar symptoms: elevated or expansive mood, grandiosity or inflated self-esteem, episodically decreased need for sleep
 b. The symptoms occur in distinct periods lasting more than 4 d
 c. The individual meets criteria for schizophrenia, schizoaffective illness, pervasive developmental disorder, or posttraumatic stress disorder
 d. The individual has met the criteria for substance abuse disorder in the past 3 mo
 e. IQ <80
 f. The symptoms are attributable to the direct physiologic effects of a drug of abuse or to a general medical or neurologic condition