{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:45:37Z","timestamp":1788547537568,"version":"build-2803163510"},"reference-count":43,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Depression and brief periods of manic symptoms are linked to a significant risk of progression to bipolar disorder (BD) in children who have a first-degree relative with BD I or II. However, little evidence exists to guide the pharmacologic management of children with these high-risk phenotypes. We propose a pharmacological treatment algorithm for high-risk youth and present results on its use in a study of children with a first-degree relative with BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Subjects were 40 youth (mean 12.7 years, range 9\u201317 years) who had (1) a first-degree relative with lifetime history of BD I or II, (2) DSM-IV-TR diagnoses of BD not otherwise specified, major depressive disorder or cyclothymic disorder, and (3) active symptoms of depression, mania, or hypomania. Participants and their families were enrolled in a randomized trial examining the effects of two psychosocial interventions on the 1-year course of mood disorder. At study intake, participants received a psychiatric evaluation and were offered medications or had existing medications optimized to decrease symptom severity. During the 1-year study, psychiatrists treated participants using a medication algorithm to treat depressive or manic symptoms as well as comorbid anxiety and\/or attention-deficit\/hyperactivity disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At study entry, 25 of 40 (62.5%) of the participants were taking at least one psychiatric medication. At 1 year, nearly an identical proportion were taking medications (22 of 35, 63%). Independent ratings indicated that in 84.7% of the study visits, physicians maintained adherence to the algorithm. No patients experienced antidepressant- or stimulant-induced mania during the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>An algorithmic approach to pharmacologic interventions may aid in the management of youth (i.e., age &lt;18) at high risk for BD. Future studies should compare outcomes in high-risk patients receiving algorithm-prescribed treatment versus those receiving treatment as usual.<\/jats:p>\n                    <jats:p>\n                      Clinical Trial Registration Information: Early Family-Focused Treatment for Youth at Risk for Bipolar Disorder;\n                      <jats:uri xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.clinicaltrials.gov\/\">www.clinicaltrials.gov\/<\/jats:uri>\n                      ; NCT00943085.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2017.0035","type":"journal-article","created":{"date-parts":[[2017,7,21]],"date-time":"2017-07-21T15:48:49Z","timestamp":1500652129000},"page":"796-805","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["A Pharmacologic Algorithm for Youth Who Are at High Risk for Bipolar Disorder"],"prefix":"10.1177","volume":"27","author":[{"given":"Christopher D.","family":"Schneck","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiki D.","family":"Chang","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa P.","family":"DelBello","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Miklowitz","sequence":"additional","affiliation":[{"name":"UCLA Semel Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,11,1]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000246070.23695.06"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e318054e724"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e318145ae1c"},{"key":"e_1_3_4_5_1","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders 4th ed. 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