Background & Objectives: Bipolar disorder in children and adolescents is a childhood critical disorder with negative course and outcome consequences. The aim of this study was determination of six-month outcome predictor factors (recurrence rate, the rate of hospitalization, severity of illness and recovery rates) in manic and mixed bipolar disorders of children and adolescents admitted in Tehran Rozbeh hospital.

  Methods: In this prospective Cohort study, 80 patients with bipolar disorder (10-18 year's old) admitted in Tehran Roozbeh Hospital from January 2009 to July 2010 were selected. The available sampling method was used for selection. Participants at admission, discharge, and follow-up at 3 and 6 months, were evaluated by using researcher made questionnaires, K-SADS (to confirm the diagnosis), CDI ( Children Depression Inventory) or BDI ( Beck Depression Inventory) , YMRS ( Young Mania Rating Scale) , CGI- S ( Clinical Global Impression Scale) , CGAS ( Children's Global Assessment Scale), CGI-S ( Clinical Global Impression Scale) and PAS ( Premorbid Adjustment Scale) . The data were analyzed by Pearson correlation coefficient and Multivariate regressions .

  Results: The results showed that disease outcome was not associated with age. Gender (male) had correlation with mania severity in 6-month follow-up. Disease duration predicted recurrence rate and severity of disease. Manic type disorder was related with mania severity, and mixed mania predicted mania severity negatively in 6-month follow-up. Therapeutic compliance was correlated with mania severity (negative correlation) and improvement rate (positive correlation). Presence of psychosis was correlated with recurrence rate positively in 6-month follow-up. Co-morbidity with ADHD ( Attention Deficient /Hyperactivity Disorder) predicted clinical global improvement (CGI-G) negatively and mania severity positively in 6-month follow-up. Pre-morbid coping showed negative relationship with mania severity and positive relation with global improvement rate in 6-month follow-up.

  Conclusion: Our results showed that gender of patients, duration and manic type of disease, presence of psychosis at admission have a direct relation with inappropriate outcome of manic and mixed bipolar disorders of children and adolescents. These findings emphasize necessity of special curing during treatment.