A recent study has discovered that children who have bipolar disorder misinterpret facial expressions-believing these expressions to be hostile-more often than their healthy counterparts. This might explain why bipolar children often tend to be more aggressive and irritable and have poorer social skills than healthy children.

The Study

Researchers at the US National Institute of Mental Health (NIMH) measured the brain activity in 22 bipolar children and 21 healthy children using magnetic resonance imaging (MRI).

When the children were asked to rate the hostility of a neutral facial expression, the area of the brain that registers fear showed more activity in the bipolar children than in the healthy children.

When the children considered a face to be hostile, other areas of the brain that are related to emotions also showed higher activity levels in the bipolar patients than in the healthy children. Activity was no different between the bipolar and the healthy children when they rated non emotional features, indicating that the differences between the groups of children are specifically related to emotional processes.


"Our results suggest that children with bipolar disorder see emotion where other people don't. Our results also suggest that bipolar disorder likely stems from the impaired development of specific brain circuits," explains Dr. Ellen Leibenluft of the NIMH Mood and Anxiety Disorders Program.

"This line of research might help us refine our definition of pediatric bipolar disorder," says NIMH director Dr. Thomas Insel. "The researchers are following up with more imaging studies of children with bipolar spectrum disorders and healthy children who are at genetic risk for developing the disorder to see if they also have the same overactivation" of this particular area of the brain.

Studying children who have bipolar disorder may provide valuable insights into the development and treatment of adult bipolar disorder, according to Leibenluft. "Since children seem to have a more severe form of the disorder, they may provide a clearer window into the underlying illness process than adult onset cases," she says.

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