Rates of Bipolar Diagnosis in Youth Rapidly Climbing, Treatment Patterns Similar to Adults
The number of visits to a doctor's office that resulted in a diagnosis of bipolar disorder in children and adolescents has increased by 40 times over the last decade, according to a study funded in part by the National Institutes of Health.
Akinso: The number of visits to a doctor's office that resulted in a diagnosis of bipolar disorder in children and adolescents has increased by 40 times over the last decade, according to a study funded in part by the National Institutes of Health. Over the same time period, the number of visits by adults resulting in bipolar disorder diagnosis almost doubled. Treatment patterns for the two groups were similar. Dr. Thomas Insel, Director of the National Institute of Mental Health discusses the rising trend.
Insel: To understand what a 40 fold increase means you have to recognize that first of all you're starting with a very low base rate. In 1994-1995, this diagnosis was used very, very really in children; only about 25 out of every 100,000 youths under the age of 19 were given this diagnosis in 1994,1995. Nevertheless it raises the question of is it simply a matter of under diagnosis in past which is now been corrected or is this diagnosis being over used today in such a way that children are getting treated with often powerful medications who really don't need to be on them. And those are questions that this paper really doesn't answer. It only provides the observation of this increase. And it ends by saying that it's not really clear what is the source for this 40 fold increase.
Akinso: While the increase in bipolar diagnoses in youth far outpaces the increase in diagnosis among adults, Dr. Insel said the researchers are cautious about interpreting these data as an actual rise in the number of people who have illness or the number of new cases each year. He added that this study reminds researchers of the need for research that validates the diagnosis of bipolar disorder and other disorders in children.
Insel: The message that I would take from this is that we need to have much better tools; we really need a tool kit, to validate the diagnosis of bipolar disorder both in adults and children. In the way this diagnosis is being used in children, it's now probably far broader when it's being used in the community than what we would like to see based on the very strict research criteria that we would use for the diagnosis. And some of that is to be expected because they're a lot of children who are in great distress and sometimes that distress involves problems with mood and problems with impulse control. They may not have bipolar disorder but they have something and so we have to get much more precise about how we use diagnosis for children to be able to know what really will be the best interventions for them.
Akinso: This is Wally Akinso at the National Institutes of Health Bethesda, Maryland.
About This Audio Report
Reporter: Wally Akinso
Sound Bite: Dr. Thomas Insel
Topic: Bipolar Disorder