Monday, September 03, 2007

Bipolar Disorder Overdiagnosed in Children

The New York Times reports on the alarming increase in the diagosis of bipolar disorder in children:
The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003, researchers are to report on Tuesday, in the most comprehensive study to look at the controversial diagnosis. And experts say the numbers have almost certainly risen further in the years since.
But others argue that bipolar disorder is overdiagnosed. The term, they say, has become a diagnosis du jour, a catch-all now applied to almost any explosive, aggressive child. Once children are labeled, these experts add, they are treated with powerful psychiatric drugs that have few proven benefits in children and potentially serious side-effects, like rapid weight gain.
“From a developmental point of view, we simply don’t know how accurately we can diagnose bipolar disorder, or whether those diagnosed at age 5 or 6 or 7 will grow up to be adults with the illness,” he said. “The label may or may not reflect reality.”
Most children who qualify for the diagnosis do not go on to develop the classic features of adult bipolar disorder, like mania, researchers have found. They are far more likely to become depressed.

Others say their children have suffered from side effects of drugs given for bipolar disorder, without getting much benefit.
Ashley Ocampo, 40, of Tallahassee, Fla., the mother of an 8-year-old boy, Nicholas Ryan, who is being treated for bipolar disorder, said that he had tried several antipsychotic drugs and mood stabilizers, and that he had been better lately.
But, she said in an interview, “He has gained weight, to the point where we were struggling find clothes for him; he’s had tremors, and still has some fine motor problems that he’s getting therapy for.”

11 comments:

Cary said...

I believe over diagnosis is the problem. Parents don't want to parent now-a-days, and at the first sign of misbehavior or aggression, throw prescription drugs at their children. This would also explain why many of the children don't carry the diagnosis with them into adulthood; they never really had it to begin with. It is not worth the risk of exposing your child to side effects like weight gain and depression without proven results and studies to back the use of this kind of medication.

sleep disorders guide said...

Hello Dr. Micheal, its me again...

Kids who don’t get enough sleep are more likely to be obese than those who gets plenty of sleep. This ensures that adequate sleep is important for controlling weight. According to the research, sleep deprivation increases the levels of hunger hormone and decreases the hormone levels that make kids feel full.

Leptin and ghrelin are the hormones that play a role in weight loss or weight gain. Leptin helps in controlling our appetite while ghrelin helps in stimulating our appetite.

When we don’t get enough sleep, it will be a disaster to our body. When we have lack of sleep, our body responds to it and produces more ghrelin hormone which is appetite inducing. Therefore, not only our sleep affects but our appetite will also be increased.

redrose said...

Hi Doctor I have a friend who has been diagnosed with bipolar disorder and his mom is trying to find a clinic who can treat him, he lives in Carthage, MS. and we would like to know your address. Thank you very much for your time and we will be waiting for your answer, if you can please help us. thank you. My e-mail is tommygirl8887@hotmail.com

peter said...

Of course over diagnosis gives out a huge problem. That too for children it might turn dangerous to them. Both parents and doctors has to take possible measures for this.

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peter

Dual Diagnosis

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Anonymous said...

Information Regarding Bipolar Disorder
Bipolar Disorder (manic-depressive illness), if a disorder at all, has been defined as a major affective mood disorder in which one alternates between the mental states of deep and brutal depression and inflated elation- with the depressive episodes occurring more frequently. The disorder affects one’s cognition, emotions, perceptions, and behavior- along with psychosomatic presentations (such as pain with depressive episodes, for example). It is thought to be due to a physiological dysfunctional brain in one affected with bipolar disorder, yet Information Regarding Bipolar Disorder
the etiology remains entirely unknown.
It is also believed that bipolar disorder presents itself when the affected one is between the ages of 15 and 25 years old. The disorder was entered in the psychiatrists’ bible, the DSM, in 1980. Also, bipolar disorder is thought to be correlated with creativity and accelerated growth of neurons if one is affected by it.
Research has determined that as many as 15 to over 30 percent of bipolar disorder patients commit suicide if they are untreated. Also, as many as half of those affected with bipolar disorder also have at times severe substance abuse issues along with this disorder as well. Bipolar patients are also often experiencing anxiety issues that vary, and are treated often as such. The disorder varies as far as severity goes- with some bipolar disorder patients being more affected than others. In fact, there are at least 6 classifications of bipolar disorder, according to the DSM.
Bipolar patients are thought to be symptomatic half of their lives- with depressive episodes occurring more frequently than manic ones. When symptomatic, bipolar patients are thought to be rather disabled, according to some. As many as half of those suspected as having a bipolar disorder are thought to have at least one parent with some sort of mood disorder, which suggests a genetic predisposition to the disorder.
The diagnosis has become more frequent recently. In one decade, the assigned diagnosis of bipolar disorder rose from being about 25 per 100 thousand people to being 1000 per 100,000 people. Most diagnosed with bipolar disorder are not diagnosed based on solid, comprehensive, or psychiatric review that is often absent of valid or standard diagnostic methods. Some believe as many as 5 percent of the human population may be affected by bipolar disorder- which includes as many as 12 million people in the United States.
A subjective questionnaire called the Mental Status Examination is often utilized when diagnosing one suspected has having bipolar disorder. Many believe the diagnosis has increased recently due to the progressive treatment options now available. It is an argument of increased awareness versus over-diagnosis.
Yet the diagnosis is vague, as children and adolescents are often absent in research with bipolar disorder. Many younger than 18 years of age are prescribed atypical anti-psychotics as first line treatment, which is largely not recommended as treatment options. In fact, close to half a million of those younger than 18 years of age are prescribed the atypical anti-psychotic Risperdal alone, it has been determined. The class of medications overall is thought to be prescribed to about 10 percent of those non-adults thought to have bipolar disorder.
While not recommended, one half of all those assessed as being bipolar are prescribed antidepressants, such as SSRIs, as first line treatment. It has been suggested that this class of drugs has decreased the risk of suicide attempts compared with other classes of antidepressants for close to 20 years. Yet tricyclic antidepressants have been determined to be efficacious in over half of those diagnosed with bipolar disorder- with a greater amount of research behind this class of drugs. Yet, entirely recognized treatments for bipolar disorder long term are lithium or lamictal- along with an anti-convulsant. Sugar intake is thought to vex the symptoms of one with a bipolar disorder as well.
Atypical anti-psychotics have been prescribed for bipolar disorder, which change some aspects of the brain, physiologically, as does the disease itself. In fact, one may argue the brain becomes more efficient due to both the disorder and the treatment with the atypical anti-psychotics. Yet many recommend the utilization of this class of drugs with bipolar disorder only if psychosis is present as well. As many as 15 percent of bipolar disorder patients diagnosed as such are prescribed an atypical presently. This class of medications may be particularly beneficial for those women who are diagnosed with bipolar disorder who are pregnant, however.
Lithium, which is essentially a very light metal with low density in which the salts are obtained for medicinal treatment, and an anti-convulsant are believed to be standard bipolar treatment, pharmacologically, studies have shown. This is due to Dr. John Cade and his examination with lithium and its benefits with those who have psychotic excitement close to 60 years ago. Lithium is believed to be both neuro-protective as well as having an anti-suicidal affect in those believed to be bipolar- and is viewed as a mainstay as far as treatment for bipolar goes with many who treat the disorder. Lithium is thought to regulate the calcium molecule in the brain, so this and valporate are historically the medicinal treatment options preferred for those with bipolar disorder.
Bipolar is difficult to detect, and is often diagnosed as major depression with many affected by this disorder. There is no objective criteria protocol available to utilize when assessing any patient believed to be suffering from any mental disorder. So such mental disorders that are diagnosed are ambiguous, yet that does not conclude that such disorders do not exist, such as the case with bipolar disorder.
Yet perhaps a health care provider should be very thorough and knowledgeable when assessing a patient believed to have a mental condition such as bipolar disorder,

Dan Abshear

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diet acomplia said...

My son also have bipolar disorder...

Depression and Anxiety said...

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