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1 Decade, 40 Times More Bipolar Kids

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

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.

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