Our son's psychiatrist has always contended this. Now there's an article in the LA Times about it:
http://www.latimes.
?coll=la-home-
Bipolar disorder in youths may be over-diagnosed
A new study says a fortyfold increase can be partly attributed to
doctors mislabeling children and teens with the illness.
By Denise Gellene, Los Angeles Times Staff Writer
4:36 PM PDT, September 3, 2007
The diagnosis of bipolar disorder in children and adolescents has risen
fortyfold since 1994, according to a study released Monday. But
researchers partly attributed the dramatic rise to doctors
over-diagnosing 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, researchers said.
The study didn't investigate the reasons for the explosion in bipolar
cases among children and adolescents, which began after the publication
of the book "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 was attributable to an under-diagnosis 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 that is treated with powerful psychotropic medications, many of
which have not been tested in children.
Dr. Thomas R. Insel, director of the National Institute of Mental
Health, which funded the study, called the increase in bipolar diagnoses
worrisome.
"The way the label is being used is probably a little exuberant -- not
fitting with the strict definition of the illness," Insel said. The
disorder "is probably not as common as the very high rates we're
seeing."
Bipolar disorder is marked by severe mood swings between depression and
mania, which is characterized by an excess of energy and restlessness.
For most patients, depressive episodes are three times more common and
longer lasting than those of mania. Symptoms of the disorder can
interfere with daily activities, and severe cases carry a risk of
suicide.
Until recently, the illness, which appears to run in families, was
seldom diagnosed in children. It was believed to begin in late
adolescence or early adulthood. About 2% of American adults are believed
to have bipolar disorder, although not all of them have been diagnosed
with the illness.
In the latest study, researchers analyzed data from an annual national
survey that collected information from doctors about the nature of
patient visits.
Researchers found striking differences between adults and the young.
Among children and adolescents, boys were more likely to be diagnosed
with bipolar disorder. 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
as bipolar. Irritability is a characteristic of bipolar disorder, he
said, but it is also a normal part of adolescence.
"The definition of bipolar disorder tells us what it looks like in
adults but not in children," Olfson said.
Young people were 10 times more likely to also receive a diagnosis of
attention deficit hyperactivity disorder than bipolar adults, the report
noted. Olfson said it was likely that some children with ADHD received
the additional diagnosis of bipolar disorder because the symptoms of the
two illnesses overlapped. For example, he said, some children and
adolescents with ADHD have a "volatile, aggressive subtype" that is
easily confused with bipolar disorder.
The report found that children and adolescents diagnosed with bipolar
disorder received the same medication as adults with the illness. Sixty
percent of children and adolescents received a mood stabilizer, and
about 33% of them received an antidepressant or antipsychotic
medication, which can cause weight gain.
Dr. Gabrielle A. Carlson, a psychiatrist at Stony Brook University in
New York, said 1 of every 5 children referred to her with a diagnosis of
bipolar disorder actually had it. The rest had autism, depression,
anxiety or another psychological disorder. All these conditions involve
different treatments, with drugs, behavioral therapy or both.
Carlson, who has studied the increase in bipolar diagnoses, said some
parents seemed to prefer a diagnosis of the disorder because the
illness, which is thought to be largely genetic, absolves them of blame.
"They don't have to deal with their chaos, their psychiatric disorder,
their marital troubles or abuse," she said.
She said that in some cases, providers would diagnose psychological
problems in children as bipolar disorder to obtain insurance
reimbursement for hospitalizations, a practice called upcoding.
Insel said his institute was conducting research that might lead to more
accurate diagnoses of bipolar disorder in young people. The agency said
recent imaging studies had detected differences between the brains of
normal children and those with bipolar disorder. A large study looking
for the genes responsible for the disorder is nearing completion and may
yield some additional clues, Insel said.
In addition, the agency is tracking children with bipolar disorder to
see how their symptoms change over time. Only a small fraction of
children referred for the study actually had bipolar disorder, Insel
said, another indication that the label is misused.
"We urgently need to improve diagnosis and treatment for these kids with
severe emotional problems," he said.
denise.gellene@
Wow, thanks for that article, tzoya. A forty-fold increase in children, mostly males, compared to a two-fold increase in adults, mostly females -- that comparison says a lot.
I have a relative whose kidneys were destroyed by a bipolar drug, so it's really scary to me to think that lots of kids are needlessly getting mood stabilizing drugs that weren't even tested on children.
I'm looking forward to the day when MEG (magnetoencephalography) can be used to identify brain disorders. The research at the U of M is very promising and could be ready for clinical use for some diagnoses within a year or two, and I'm assuming that it could eventually be used for bipolar. Right now it's had promising use conditions as varied as Alzheimer's, chronic alcoholism, schizophrenia, multiple sclerosis, Sjogren's syndrome (an autoimmune disease), and facial pain!
If anyone missed the article posted by Micki awhile back, here it is:
http://www.startribune.com/1244/story/1377928.html
That is a very interesting article, thanks a bunch tzoya! I find it very interesting because both Chris and Billy have been dx bipolar. Billy was definitely mis dx. Billy has autism. I think that Chris has autism also, he will be evaluated soon. Maybe there are bipolar traits just like there are asd traits. Do we needI do not know what ot make of it either, Micki. Thing is, meds are a godsend to those who need them -- and to their parents.
... but what if we DO medicate too many kids, instead of letting them learn to self-regulate? What is going to happen to them ... and to our society?
I saw this at yahoo.com tooSO ... maybe it is NOT just that it is comorbid with autism ... but that autistic are more apt to see shrinks? Shrinks who are apt to read literature from pharmaceutical cos.?
SIGH. Definitive diagnosis would be wonderful!
ThANkS SINCE dANIEL'S DX RIGHT NOW IS BP/ADHD.momofmany- autism falls under schitzophrenia? I know my sons doctor said they are in similar categories or something because I was worried since bipolar and schitzophrenia run in mine and husbands family. Why does it fall under it? Or is that what you mean thier just similar characteristics? Im curious, sometimes I wonder if my son is or that maybe im just dramatic? And hes also so young too.|
My childs developmental/behavioral ped said that he doesn't believe in diagnosing bipolar disorder until age 12. To get a kid on the meds approved by insurances, they have to submit a different diagnosis such as OCD, ODD or others. My cousins little boy was diagnosed at age 2 with bipolar, ADHD, and he has cerebral palsy. I think they diagnosed him too young and she needs to get him out of the boone docks to an appropriate doctor. I do have family members with bipolar so it is a wait and see game. What a lot of ppl don't understand is that autism falls under scitzophrenia(bad spell) so behavior can mimic some symptoms of bipolar. |
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that is just the way they classify it. I never knew if did fall under schitzophrenia until I took a medical terminology class.
my Language of Medicine book says:
Impaired interpersonal functioning and relationship to the extermal world such as emotional detachment and social withdrawl. Autism(preoccupatation with self-centered, illogical ideas and fantasies that exclude the external world) is often a feature of schizophrenia. |
I searched it online and it seems alot came up about autism and scizophrenia. It says autism used to be called childhood scizophrenia. This site was really interesting.