Posttraumatic stress disorder (PTSD) symptoms in sexually abused adolescents often overlap with many other diseases, such as conduct disorder and bipolar disorder (BD). In this paper, the difficulties encountered in making the differential diagnosis of BD and PTSD will be discussed with clinical outcomes of five cases. The follow-up findings and differential diagnosis of five cases were evaluated throughout their hospitalization and after discharge. All of these cases have been abused physically, sexually or emotionally by their family members or adult strangers. Two cases had a positive family history of BD. One case switched to manic state due to antidepressant treatment prescribed for PTSD symptoms. Dissociative symptoms and irritability were common and atypical antipsychotics and mood stabilizers have been used for the treatment of these mixed clinical states. Many symptoms of PTSD and BD are very similar. Moreover, children and adolescents with BD are under greater risk for sexual abuse or vice versa are also correct. Clinicians should take into consideration both clinical states during clinical and pharmacological management of these patients.
Key words: posttraumatic stress disorder, bipolar disorder, sexual abuse
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