1/2-MC4R Genotype and Pediatric Antipsychotic Drug- Induced Weight Gain

Inclusion Criteria: * age 13-18 years * English-speaking * DSM diagnoses that have an FDA indication for SGA use for at least one agent in the respective pediatric or adult age group. Specifically, primary DSM-IV diagnosis of early-onset schizophrenia spectrum disorders; bipolar I disorder mania (and BP-NOS); irritability associated with autism spectrum disorder, as well as severe mood dysregulation (SMD) according to Leibenluft et al. (2011) with an ABC-irritability score of \>/=18 Sexually active girls must agree to use two effective forms of birth control or be abstinent * Participant has a primary caretaker who has known the child well for at least 6 months before study entry Primary caretaker is able to participate in study appointments * Ability of child to participate in all aspects of the protocol per investigator clinical judgment. Exclusion Criteria: * Major neurological or medical illnesses that affect weight (e.g., unstable thyroid disease), require a prohibited systemic medication (e.g., diabetes mellitus \[insulin\], chronic renal failure \[steroids); Fasting glucose \> 125 mg/dL on 2 occasions during screening * Any medication (other than currently prescribed psychotropic medications) that would significantly alter weight * Antidepressants not allowed for at least 2 weeks in BP-I or BP-NOS patients * DSM-IV diagnosis of anorexia or bulimia nervosa * DSM-IV diagnosis of Substance Dependence disorder (other than tobacco dependence) within the past month * Initial urine toxicology screen and follow-up screen indicate ongoing use of illicit substance * Hypersensitivity to ZIP or UC antipsychotics * Pregnant, breast feeding or unwilling to comply with contraceptive requirements * Screening or baseline QTc \> 450 msec * IQ \< 55 * Significant risk for dangerousness to self or to others * Ongoing or previously undisclosed child abuse requiring new department of social service intervention.