In the 1980s, with the transition from the DSM II to the DSM III, the possibility for an adolescent to present a bipolar disorder became close to non-existent. Adolescent psychodynamic psychiatrists did not agree with this change and stayed with the old classification. Nevertheless, DSM III led to a decrease of bipolar diagnosis in adolescents especially in Anglo-Saxon countries, even becoming a rarity in the 2000s. Now, the evolution of current criteria for adolescents tends to bring these two approaches closer together. Despite the differences, there is a consensus regarding the poor prognosis of type I bipolar disorder, particularly when psychotic traits are observed. Early diagnosis and treatment are therefore important, yet they both remain a challenge, with each having limitations inherent to their respective approaches. In classical psychiatry, if the criteria are met for bipolar disorder, treatment is started right away amid the risks of over-diagnosis and the stigmatization of false positives. For psychodynamic psychiatrists, even if the criteria for bipolar disorder are met, it is still necessary that the psychopathological analysis of the disorder in the developmental framework of adolescence confirms that the disorder is stable, at the risk of delayed treatment and increased or insufficiently treated false negatives.
Keywords: mood disorder, bipolar disorder, adolescence, nosology