Skip to content
My WebMD Sign In, Sign Up

Bipolar Disorder Health Center

Font Size
A
A
A

1 Decade, 40 Times More Bipolar Kids

Child Bipolar Explosion -- or Rampant Misdiagnosis?
By
WebMD Health News
Reviewed by Louise Chang, MD

Kids Bipolar Diagnoses Rising

Sept. 4, 2007 -- Today's children and teens are 40 times more likely to have bipolar disorder than were the children of 10 years ago.

That's 20 times faster than the growth in diagnoses of adult bipolar disorder over the same decade. Are we only now discovering a huge reservoir of untreated psychiatric illness? Or is there an epidemic not of disease, but of misdiagnosis and overtreatment?

The study that provides this alarming data doesn't answer this crucial question, says study researcher Mark Olfson, MD, MPH, professor of clinical psychiatry at Columbia University Medical Center and New York State Psychiatric Institute.

"We found a striking national increase in the treatment of young people for bipolar disorder: from 20,000 youths in 1994 to 800,000 youths in 2003," Olfson tells WebMD. "The study does not tell us why so many more kids are being diagnosed and treated for bipolar disorder. But it gives us clues."

Those clues:

  • Bipolar disorder is often a lifelong condition. More bipolar disorder in children should mean a corresponding increase in adults with bipolar disorder. Olfson says that isn't happening. This means we're either discovering previously unrecognized bipolar disorder in children, or that we're misdiagnosing children.
  • Youths diagnosed with bipolar disorder are more likely than adults to also be diagnosed with ADHD (attention deficit hyperactivity disorder).
  • Most adults diagnosed with bipolar disorder are female. Most children and teens diagnosed with bipolar disorder are male. "It is my sense that most of these people are boys around age 12, and many have ADHD or at least are treated for that with stimulants," Olfson says.
  • During the 10 years covered by the study, the diagnostic criteria for bipolar disorder have broadened. "Many adults and young people who would not have been considered to have bipolar disorder now are," Olfson says.

Definition of Childhood Bipolar Disorder Controversial

What, exactly, is childhood bipolar disorder? It's controversial. Bipolar disorder used to be called manic depression because it is characterized by bouts of depression and bouts of mania.

Mania in adults is characterized by euphoria, grandiosity, irritability, racing thoughts, and frenetic activity. While some experts argue that childhood mania must also exhibit signs of euphoria and grandiose behavior, others say irritability may be the only sign.

"In children, the symptoms of bipolar disorder are very different from the symptoms in adults," Julio Licinio, MD, chairman of the department of psychiatry at the University of Miami, tells WebMD.

In January 2007, the American Academy of Child and Adolescent Psychiatry (AACAP) set out a "practice parameter" acknowledging the controversy. The AACAP's expert panel noted that for both children and adults, doctors are much more often diagnosing bipolar disorder based on individual symptoms rather than characteristic patterns of symptoms.

The AACAP panel noted that there's also debate over whether bipolar disorder in children is even the same illness as bipolar disease in adults. What is agreed on is that bipolar disorder is an increasingly common diagnosis in children -- including preschool children.

"There was a real underdiagnosis of bipolar disorder in children. We've gone to the other situation now," Licinio says. "Some of these children are just irritable and cranky and negative. They get more brittle than manic. And people can mistake juvenile delinquency for bipolar disorder. So there is a potential for this to be really missed."

Today on WebMD

bipolar overview slideshow
Article
brain food
SLIDESHOW
 
Bipolar or Schizophrenia
Article
Woman lost in thought at the beach
Article
 
Feeling Ups and Downs
HEALTH CHECK
Foods to Avoid
Article
 
Anger And Depression
Video
Bipolar or Schizo
Video
 
Women and Bipolar
Article
Bipolar Symptoms
VIDEO
 
What is Mania
Article
MRI of a human brain
Slideshow
 

WebMD Special Sections