According to various news sources in the US today, Bipolar Disorder ‘soars as a diagnosis for the young’.

This is referring to a study in the Archives of General Psychiatry. The conclusion of the study is:

There has been a recent rapid increase in the diagnosis of youth bipolar disorder in office-based medical settings. This increase highlights a need for clinical epidemiological reliability studies to determine the accuracy of clinical diagnoses of child and adolescent bipolar disorder in community practice.

Just like in another mental difference that touches my life, this increase in diagnosis has occurred during the early 90’s to early noughties. To what might we attribute that?

On a purely pragmatic level we can say that, these results were found because that’s where the study team looked. I know of a group of people who will fasten onto this as more ‘evidence’ to support their conspiracy theories about the evils of vaccinations.

However, the study team are taking a much more skeptical line here. They are essentially saying ‘well, lets go back and make sure that diagnosticians at the ‘coal face’ are giving the right diagnosis to these youngsters’. That seems an eminently sensible approach to me. Its not intended to cast aspersions on anyone’s diagnosis or on anyone’s skills as a diagnostician but merely to practice good science and make sure this very basic step is covered.

One of the fascinating things the New York Times article highlights is the differences between the US and UK experience of epidemiology. The New York Times states for example:

Until relatively recently, it was thought to emerge almost exclusively in adulthood.

Whereas in the UK, it has been accepted for some years that:

....the average age of onset is early adolescent to early twenties.

I received my initial diagnosis in my early adolescence.

The NYT goes on to say:

Other experts say bipolar disorder is overdiagnosed. The term, the critics say, has become a catchall applied to almost any explosive, aggressive child.

This is an odd statement. Explosive aggression on its own cannot be used to diagnose manic depression. If it really is the case that US kids are being diagnosed with Bipolar I or II based solely on ‘explosive aggression’ then it is indeed recommended that their cases are re-examined.

Most children who qualify for the diagnosis do not proceed to develop the classic features of adult bipolar disorder like mania, researchers have found. They are far more likely to become depressed.

This is troubling. That these kids need help is beyond question. That they are getting the right help if they’re being treated for manic depression if what they really have is clinical depression is an open question. People being given mood stabilisers know the effect they can have on ‘uppers’ such as Prozac. Its not a good effect. These kids need to be accurately assessed, not just shotgunned into bipolarity.