Bipolar disorder is a chronic psychiatric illness that often
begins in adolescence. Comprehensive studies of moderate- to
long-term outcome in patients with adolescent-onset bipolar
disorder have only just begun to be reported (1–5). In a
previous paper, we reported on a group of adolescents with
bipolar I disorder, the large majority of whom had an overall
profile of good premorbid academic functioning that deteriorated
over 4 years after the onset of bipolar illness (6). After
illness onset, areas of language, art, athletics, or music were
identified as academic strengths by 95% of the adolescents’
teachers, whereas mathematics was ranked the most problematic
area of study by 60% of the teachers. To our knowledge this was
the first and only report describing mathematical deficits in
youth with bipolar disorder. Academic difficulties in
adolescents with bipolar disorder have been attributed primarily
to adjustment problems, the effects of multiple
hospitalizations, and difficulties with peers (7–10). Althoug