A new analysis suggests there's been a huge increase in the number of American children diagnosed with bipolar disorder, but experts question whether the surge is real and say some kids have been mislabeled.
Researchers looked at the number of times children under 19 went to a doctor and were diagnosed with or treated for bipolar disorder, also known as manic-depression. They found a 40-fold increase, from an estimated 20,000 visits in 1994 to 800,000 in 2003.
The jump coincided with children's rising use of anti-psychotic medicine.
The numbers echo other estimates suggesting as many as 1 million U.S. children are bipolar, but it remains a controversial diagnosis in children. That's partly because their symptoms often differ from those of adults, and because most powerful anti-psychotic drugs used to treat bipolar disorder were approved for adults and have not been well-studied in children.
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Some doctors believe bipolar disorder doesn't occur in children, and until last month there was only one drug approved to treat this mental illness in kids.
The study's lead author, Dr. Mark Olfson of Columbia University and the New York State Psychiatric Institute, said the results likely reflect over-diagnosis now or under-diagnosis in the past, rather than a true increase.
Dr. Sharon Hirsch, a University of Chicago psychiatrist, said that while she is treating increasing numbers of bipolar children, she doubts that there's a "vast epidemic."
More public awareness about mental illness, spurred partly by heavy marketing of psychiatric drugs, could have contributed to the surge. And early in the study, a leading manual of psychiatric illnesses expanded criteria for diagnosing bipolar disorder, Olfson noted.
Symptoms include extreme mood swings and disruptive behavior. In children, extreme irritability is sometimes the main symptom.
Dr. David Fassler, a University of Vermont psychiatry professor, said research suggests that close to half of children thought to be bipolar may be misdiagnosed, and he advises that parents get a second opinion if they're uncertain.
On the Net
Archives of General Psychiatry: www. archgenpsychiatry.com
