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Clinical Assessment of Pediatric Bipolar Disorder in the Prepubescent Population

Abstract Purpose: Diagnosis of serious mental illness (SMI) in the prepubertal pediatric population is exceedingly challenging. There is ongoing controversy associated with the diagnosis of pediatric bipolar disorder (PBD), largely due to poor clinical consensus surrounding criteria particularly in the youngest cohort. Specificity of symptom identification is invaluable as it relates to available empirical evidence, and wider classification characteristics appear to detract from this precision. The aim of this project is to present the current evidence around the diagnosis of PBD before adolescent onset and to summarize best practice guidelines from an ethical and theoretical perspective (Bronfenbrenner’s Bioecological Theory of Human Development). Edification of the current evidence with the intended outcome of increased knowledge/awareness of current PBD issues is the stated goal. Methods: The project was designed using a quality improvement (QI) approach with the aim of enhancing nursing knowledge of PBD using pre and post questionnaires. Acquisition of material was measured using a simple formula to predict learning gain (g). Results: This QI project included the development of a Toolkit based on best practice guidelines. Participants were registered nurse’s working at a hospital in New England. Posttest scores revealed an average learning gain of 90%. Short-term goal of increased knowledge base was achieved. Conclusion: Nurses at a hospital in the Northeast enhanced their knowledge base and critical evaluation skills around issues of PBD, as well as consideration of multiple variables when considering a diagnosis of a SMI in a young child. The project was recommended to become a part of the nursing curriculum at the hospital site. Keywords: pediatric bipolar disorder, prepubescent/prepubertal, quality improvement