1 Decade, 40 Times More Bipolar Kids
Child Bipolar Explosion -- or Rampant Misdiagnosis?
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
Worrisome as they are, drug side effects are not the only problem facing
children diagnosed with bipolar disorder. There's also the stigmatization of
having a serious, possibly lifelong mental illness.
"School personnel may treat the child differently, the options for
things like after-school programs and summer camp may be limited, and there may
be problems with getting health insurance," Olfson says. "And the
children may give up on themselves if they think they have a brain disorder
that has no cure. So there is the potential for serious risks."
So what should parents do if their doctor suspects their child has bipolar
"It can be a devastating thing for a parent to hear," Olfson says.
"Rather than overreact, parents should ask how the diagnosis was made. Did
the provider talk with the child's teachers? Did the psychiatrist or another
doctor look at the child over time? How much information went into this
Before deciding on treatment, Olfson recommends that parents consult an
expert in child and adolescent psychiatry.
Licinio says that while there may be a trend to overdiagnose bipolar
disorder in children, there are still many children who would benefit from
having their bipolar disorder recognized and treated.