In The Lancet Psychiatry, three Australian psychiatrists analyze the modern history of bipolar disorder in children, and explore how it came to be that, “By 2004, bipolar diagnoses in children and adolescents had increased 40 times in US primary health care and become the most common diagnosis in preadolescent inpatient units.”
“Between 2000 and 2010, mean bipolar diagnoses for children aged up to 19 years were 100.9 per 100,000 children in 50 US inpatient units, peaking at 140 per 100,000 children in 2006,” they write. “By contrast, the rate was 1.4 per 100,000 children and adolescents aged up to 19 years from all English inpatient units.”
The authors point to a variety of critiques on what happened, such as how “diagnostic criteria for paediatric bipolar disorder deviate from strict DSM criteria; symptom-checklist approaches to diagnosis did not account for developmental and contextual factors; trauma and attachment disruption were overlooked; the pharmaceutical industry collaborated with key opinion leaders and researchers of paediatric bipolar disorder; and that the US health system often mandates more serious diagnoses in order to provide reimbursement, which fosters diagnostic upcoding.”
(Free registration) Reification of the paediatric bipolar hypothesis in the USA (Parry, Peter et al. The Lancet Psychiatry. November 30, 2014. DOI: http://dx.doi.org/10.1016/S2215-0366(14)00075-3)
http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366%2814%2900075-3/fulltext
