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Although for years it was felt to be almost nonexistent, very-early-onset bipolar disorder (before age 12) has become an important member of the mood disorder spectrum of youths. Whether there is a separate subtype characterized by severe irritability or whether the problem of emotionally explosive children is better explained by other conditions is still being resolved. The diagnosis of bipolar I disorder requires an episode of mania, and understanding those manic symptoms is the source of differences in interpretation.