Huge Increase In Youth Bipolar Disorder Diagnoses Since 1994

Editor's Choice
Main Category: Bipolar
Also Included In: Psychology / Psychiatry;  Pediatrics / Children's Health
Article Date: 03 Sep 2007 - 13:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

In 1994 twenty-five per 100,000 people aged 19 and under were diagnosed with Bipolar Disorder in the USA. In 2004 the figure jumped to 1,003 per 100,000. The number of adults diagnosed with Bipolar Disorder during the same period almost doubled. You can read a report about this in Archives of General Psychiatry (JAMA/Archives), September issue.

Bipolar disorder is a mental illness which generally involves periods of abnormally elevated mood (mania) followed by the opposite (depression). The authors write "Although bipolar disorder may have its onset during childhood, little is known about national trends in the diagnosis and management of bipolar disorder in young people."

Carmen Moreno, M.D., Hospital General Universitario Gregorio Maranon, Servicio de Psiquiatria, Madrid, Spain, and team looked at data from a US-wide survey of office-based doctors designed to represent all such clinicians in the country. The doctors supplied information about demographic, clinical and treatment aspects of each patient visit over a one-week time period. They then compared the rate of bipolar disorder diagnoses growth among people aged up to 19 in one case, and people aged at least 20 in another. Comparisons were made regarding demographic information and prescribed treatments between the two groups (young people and older people) during 1999 to 2003.

This is what they found:

-- annually, the number of office-based visits with a bipolar disorder diagnosis for those aged 19 and less rose from 25 per 100,000 in 1994 to 1,003 per 100,000 in 2003.

-- Annually, the number of office-based visits with bipolar disorder diagnosis for those aged 20 and over rose from 905 per 100,000 to 1,679 per 100,000.

-- 0.44% office based visits had a diagnosis of bipolar disorder among the people aged 19 and less, compared to 0.01% in 1994.

-- 0.5% office based visits had a diagnosis of bipolar disorder among the people aged 20 and over, compared to 0.31% in 1994

-- During 1999-2003 66.5% of the younger patients diagnosed with bipolar disorder were male

-- During 1999-2003 67.6% of the older patients diagnosed with bipolar disorder were female

-- 32.2% of the younger people who were diagnosed with Bipolar Disorder were also diagnosed with ADHD

-- 3% of the older people who were diagnosed with Bipolar Disorder were also diagnosed with ADHD

The authors wrote "The impressive increase in the diagnosis of childhood and adolescent bipolar disorder in U.S. office-based practice indicates a shift in clinical diagnostic practices. In broad terms, either bipolar disorder was historically under-diagnosed in children and adolescents and that problem has now been rectified, or bipolar disorder is currently being over-diagnosed in this age group. Without independent systematic diagnostic assessments, we cannot confidently select between these two competing hypotheses."

90.6% of the youths and 86.4% of the adults who were diagnosed with Bipolar Disorder were prescribed medications for bipolar disorder, including mood stabilizers, anti-psychotics and antidepressants. The similarities were present even though bipolar disorder may affect children differently to adults.

The authors concluded "There is an urgent need to study the reliability and validity using multiple informant strategies of the diagnosis of child and adolescent bipolar disorder in community practice and to evaluate the effectiveness and safety of pharmacological treatment regimens commonly used to treat youth diagnosed with bipolar disorder."

Archives of General Psychiatry

Written by: Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today