Chicago – A new analysis suggests there has been a huge increase in the number of U.S. 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 people under age 19 went to the 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 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.
Some doctors believe bipolar disorder doesn’t occur in children, and until last month there was only one drug approved to treat the 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 overdiagnosis now or underdiagnosis in the past, rather than a true increase. Olfson has received speaking fees from Janssen LP, which makes one of the pediatric bipolar drugs, and has consulted for other makers of psychiatric drugs.
Dr. Sharon Hirsch, a University of Chicago psychiatrist, said that while she is treating increasing numbers of bipolar children, she doubts 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.
Symptoms include extreme mood swings and disruptive behavior. In children, extreme irritability is sometimes the main symptom.
It affects more than 5 million adults. The causes are uncertain, but the disorder tends to run in families.
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. He said parents should get a second opinion if they have concerns about a diagnosis.
“Bipolar disorder is not always easy to recognize in children and adolescents. There’s considerable overlap with other conditions, including ADHD, conduct disorder, anxiety disorders and depression,” said Fassler, who was not involved in Olfson’s study.
The study appears in the September issue of Archives of General Psychiatry.
Charlie Crow, 13, of Verona, N.J., who was diagnosed with bipolar disorder in 2001, said the results don’t surprise him because he knows lots of other kids who are bipolar. When he was first diagnosed at age 7, though, he felt alone and isolated. He said it helps to know there are other kids like him.
“They know how I feel, and I know how they feel,” he said.
