Hafeman DM, Rooks B, Merranko J, et al. - Researchers examined outcomes for bipolar disorder (BD) treatment, including mood symptoms and suicidality, following lithium (LI) vs other mood-stabilizing medication (OMS) using data from the Course and Outcome of Bipolar Youth (COBY) study. COBY is a naturalistic, longitudinal study which included 413 youth with BD. Over a mean follow-up of ten years, 340 participants provided 2,638 six-month follow-up periods (886 LI, 1,752 OMS). In line with adult studies, findings indicated an association of LI with decreased suicidality, less depression, and better psychosocial functioning. The LI group vs the OMS group had half as many suicide attempts, fewer depressive symptoms, less psychosocial impairment, and less aggression following covariate adjustment. Comparable findings were seen in the subgroup of follow-up periods where participants were <18 years old. These findings seem to be significant clinically for the pharmacological management of youth with BD given a lack of evidence regarding lithium in children and adolescents.