1 Decade, 40 Times More Bipolar Kids
Child Bipolar Explosion -- or Rampant Misdiagnosis?
WebMD News Archive
Definition of Childhood Bipolar Disorder Controversial continued...
"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."
Treatment of Children With Bipolar Disorder
Olfson and colleagues used data collected annually by the National Center
for Health Statistics. The data come from questionnaires given to office-based
doctors who directly treat patients. The study compared reports on treatment of
bipolar disorder in adults with reports of bipolar disorder treatment of
children/teens aged 0 to 19 years.
The Olfson team's report, in the September issue of Archives of General
Psychiatry, shows that doctors treat bipolar disorder in youths the same
way they treat it in adults: with powerful psychiatric drugs.
In two-thirds of visits, youths
diagnosed with bipolar disorder receive mood stabilizers -- most often
anticonvulsants such as Depakote. Children are just as likely as adults to be
treated with antipsychotic drugs, although children are more likely to receive
the newer "atypical" antipsychotics. In six out of 10 visits, patients
regardless of age receive a combination of at least two drugs.
"The types of medications they receive resemble those received by
adults," Olfson says. "There are real risks associated with
misdiagnosis of children with bipolar disorder. These drugs have powerful side
effects and their long-term safety has not been established for