Nearly Half of Children with Bipolar Disorder Possibly Misdiagnosed

CHICAGO – Experts are questioning whether the recent surge in bipolar disorder diagnoses in children is an accurate reflection.

Estimates suggest that approximately 1 million U.S. children are bipolar. The disorder affects more than 5 million adults. Researchers found that four times the number of children visited the doctor and were diagnosed with or treated for bipolar disorder in 2003 than in 1994.

The lead author of the study, Dr. Mark Olfson, of Columbia University and the New York State Psychiatric Institute, said the results may demonstrate a current tendency to diagnose or a past tendency to under-diagnose instead of a real increase.

The study is published in the September issue of the Archives of General Psychiatry.

The spike in numbers may have partially been caused by an increased public awareness of mental illness and aggressive marketing of psychiatric drugs.

Research suggests that nearly half of children thought to be bipolar could possibly be misdiagnosed, said Dr. David Fassler, a University of Vermont psychiatry professor, who was not involved in Dr. Olfson’s study. He recommends that parents seek a second opinion if they are concerned about a diagnosis.

The study results come after a report last June showing a large increase in U.S. children being hospitalized with bipolar disorder, from 1.3 per 1,000 in 1996 to 7.3 per 10,000 in 2004. The report was published in the journal Biological Psychiatry. Adult visits for bipolar disorder also increased during the study but not as drastically.

Disruptive behavior and mood swings are two symptoms of the disorder. Extreme irritability is sometimes the primary symptom found in children. The causes of bipolar disorder are uncertain, but it tends to run in families. It can be difficult to recognize in children and adolescents because there is significant overlap with other conditions, including anxiety disorders, depression, ADHD and conduct disorder, according to Dr. Fassler.

Bipolar disorder, also known as manic depression, is still a controversial diagnosis for a child. Their symptoms differ from those of adults. Most antipsychotic drugs used to treat the disorder have been approved for adults but have not been extensively studied for children. Some doctors do not think it is even possible for children to have the disorder.

A generation ago, bipolar children were probably mislabeled as troublemakers, but many say the condition has always existed.

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