A comment on an important Question in psychiatry (QuiP): Whether paediatric bipolar disorder a valid diagnosis?

BackgroundControversy surrounds the diagnosis and prevalence of paediatric bipolar disorder, with estimates varying considerably between countries.AimsTo determine the international hospital discharge rates for paediatric bipolar disorder compared with all other psychiatric diagnoses.MethodWe used national data-sets from 2000 to 2010 from England, Australia, New Zealand, the USA and Germany.ResultsFor those aged under 20 years, the discharge rates for paediatric bipolar disorder per 100 000 population were: USA 95.6, Australia 11.7, New Zealand 6.3, Germany 1.5 and England 0.9. The most marked divergence in discharge rates was in 5- to 9-year-olds: USA 27, New Zealand 0.22, Australia 0.14, Germany 0.03 and England 0.00.ConclusionsThe disparity between US and other discharge rates for paediatric bipolar disorder is markedly greater than the variation for child psychiatric discharge rates overall, and for adult rates of bipolar disorder. This suggests there may be differing diagnostic practices for paediatric bipolar disorder in the USA.

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Paediatric Bipolar Disorder

Australasian Psychiatry ◽

10.1177/000486740801600403 ◽

2008 ◽

Vol 16 (4) ◽

pp. 295-295

Author(s):

David Healy

Keyword(s):

Bipolar Disorder ◽

Paediatric Bipolar Disorder

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Comparison of Diagnostic Guidelines for Juvenile Bipolar Disorder

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670701342200 ◽

2007 ◽

Vol 41 (6) ◽

pp. 479-484 ◽

Cited By ~ 8

Author(s):

Catherine Cahill ◽

Tanya Hanstock ◽

Rajeev Jairam ◽

Philip Hazell ◽

Garry Walter ◽

...

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Clinical Practice ◽

Clinical Excellence ◽

Systematic Search ◽

Future Research ◽

Child Psychiatric ◽

Key Features ◽

Paediatric Bipolar Disorder

The purpose of the present paper was to compare currently available diagnostic guidelines for juvenile bipolar disorder with respect to utility in research and clinical practice. A systematic search of psychiatric, medical and psychological databases was conducted using the terms ‘juvenile bipolar disorder’, ‘paediatric bipolar disorder’ and ‘guidelines’. Three main sets of guidelines issued by the National Institute of Health and Clinical Excellence (UK), The National Institute of Mental Health (USA) and Child Psychiatric Workshop (USA) were found. There were key differences in the recommendations made by each regarding the diagnosis and symptomatic presentation of juvenile bipolar disorder. Although the diagnosis of juvenile bipolar disorder is gaining increased recognition, its definition remains controversial. It is recommended that clinicians and researchers need to develop diagnostic guidelines that have clinical salience and can be used for future research by incorporating key features of those that are currently available.

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