Children With Bipolar Disorder: Medical Fact or Dangerous Fad?
Despite his critique of the study, Rosenfeld "agrees completely" with Weller's conclusion that overdiagnosis and treatment of pediatric bipolar disorder is an immediate and growing threat to children.
"If you look at Amazon.com's best-seller list on parenting, there are two or three books on 'the bipolar child'," he says. "I've had five-year-olds referred to me who were supposedly ... diagnosed with [bipolar disorder], and I have colleagues who've seen up to 10 of these kids in a month. It's a scandal." Rosenfeld tells WebMD that the authors of the extremely popular books are "not child psychiatrists and the kids they're describing are not bipolar." Even so, "parents are jumping to conclusions, and the kids are being put on medications they don't need. That's really the issue."
Exactly, says Weller. To date, according to her, none of the drugs being used to treat bipolar disorder has been tested and proven superior to a placebo in good clinical trials. "Why would you expose children to medications for which you don't even know the long-term effects on the developing central nervous system?" she asks. Caution should be the operative word.
Yes, say both experts, the bipolar disorder is real. And yes, it's important to catch it early, as delayed diagnosis and treatment can mean a worse long-term outcome. But there is certainly no pediatric bipolar disorder epidemic. "[Bipolar disorder] affects 1% of the adult population, 1% of the adolescent population, and we don't know, but we guess that it's also 1% of the prepubescent population," says Weller. "So it's there, but the chance of an average doctor seeing a lot of cases is very low."
So why the sudden hysteria? Weller tells WebMD that it's a combination of factors. "Twenty years ago when we first described pediatric [bipolar disorder], no one believed that these kids existed. Now any child throwing a severe tantrum is shipped to the doctor to see if they are bipolar. Parents are desperate to get help, and clinicians are willing to do whatever it takes to get these kids to settle down."