Although lithium is now established in adult psychiatric care, its place in child and adolescent psychiatric treatment is still not clear. This is surprising, particularly because the first report on the use of lithium in the younger age group appeared in 1959, almost 20 years ago. This was the publication by Van Krevelen and Van Voorst,1 in which the authors described the successful treatment of a 14-year-old boy who suffered from "periodic psychosis with longer manic and shorter depressive phases." This patient appeared to have been suffering from manic depressive illness. The two reports which followed this were by Frommer2 in England (1968) and Annell3 in Sweden (1969). Frommer described a group of 19 young people, aged 5 to 14 years, whom she treated with lithium and who displayed depressive features with extreme forms of "temper outbursts alternating with brief states of reasonableness," or who showed "continuous