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In this chapter, we discuss contemporary knowledge concerning the manifestations, development, risk factors, prodromes, and neuropsychological findings of bipolar disorder (BP) in children and adolescents. Because this topic has been widely discussed, we have attempted to review the available literature critically and evaluate contradictory findings. Major controversies include the relationship between BP and attention-deficit hyperactivity disorder, the prevalence of mania in childhood, and diagnostic challenges, the problem of irritability, and the diagnosis of disruptive mood dysregulation disorder. The latter condition emerged as a reaction to the trend in the United States of diagnosing BP excessively in children. We have not included a section about treatment because of methodological weaknesses in most available studies.