Bipolar Diagnoses Skyrocket in Children

http://www.charlotte.com/171/story/262529.html

The diagnosis of bipolar disorder in children and adolescents has risen fortyfold since 1994, according to a new study released Monday. But researchers partly attributed the dramatic rise to doctors overdiagnosing the serious psychiatric disorder.

The report in the journal Archives of General Psychiatry said bipolar disorder was found in 1,003 of every 100,000 office visits from children and adolescents in 2002-03, compared with 25 of 100,000 office visits in 1994-95.

The diagnosis of bipolar disorder among adults increased twofold during the same period.

The study didn’t investigate the reasons for the explosion in bipolar cases among children and adolescents, which began after the 1998 publication of “The Bipolar Child,” which made the controversial assertion that one-third to one-half of children with depression had bipolar disorder.

Dr. Mark Olfson , a psychiatrist at Columbia University’s College of Physicians and Surgeons and senior author of the latest study, said part of the increase can be attributed to an underdiagnosis of bipolar disorder in the past.

But Olfson said another reason was the mislabeling of children and adolescents with aggressive or irritable behaviors as bipolar, an illness treated with powerful psychotropic medications.

Dr. Thomas Insel , director of the National Institute of Mental Health, which funded the study, called the increase in bipolar diagnoses worrisome.

The disorder “is probably not as common as the very high rates we’re seeing,” Insel said.

Bipolar disorder’s symptoms can interfere with daily activities. Severe cases carry a risk of suicide.

Among children and adolescents, boys were more likely to be diagnosed with bipolar disorder, the latest study found. Among adults, the illness is more common in women.

Olfson said the gender difference between the groups suggested that some boys with behavior problems or conduct disorders were being misdiagnosed. Irritability is a characteristic of bipolar disorder, he said, but it also is a normal part of adolescence.

Why am I not surprised?