The geography of a controversial diagnosis: A bibliographic analysis of published academic perspectives on ‘paediatric bipolar disorder’

Background: The hypothesis that bipolar disorder presents before puberty with atypical mania has proved to be controversial. Published academic perspectives on the validity of Paediatric Bipolar Disorder (PBD) appear to vary between the United States and the rest of the world. Methods: We examined the perspectives of articles citing four seminal articles. The citing articles were grouped as either supportive or non-supportive of the PBD hypothesis, and the perspectives of the articles by US authors were compared with those by non-US authors. Results: There were 787 citing articles commenting on PBD, mostly published in US-based journals. Most authors were affiliated with several US institutions. Among the 624 articles with US authorship, the majority (83%) supported PBD. Of the 163 articles by non-US authors, most (60%) supported the traditional view that bipolar disorders are rare before mid-adolescence. Published academic perspectives in favour of the PBD hypothesis are mostly concentrated in several US institutions. Conclusion: There is majority support for PBD among citing articles from the United States, whereas the traditional perspective predominates in articles from most other countries.

Depressive Disorders in Childhood and Adolescence

This chapter focuses on depressive disorders in childhood and adolescence. Depression in children and adolescents is a complex and debilitating disease, and typically has a lifelong, chronic, and recurrent course. The peak age of onset of depression is between 13 and 15 years. After providing a clinical picture of depression, this chapter discusses early childhood depression and differential diagnosis, including paediatric bipolar disorder, psychotic depression and seasonal affective disorder, oppositional and conduct disorder, and substance misuse and medical conditions. It then examines comorbidity, paying attention to bipolar disorder and suicidal behaviour, along with the assessment and prevention of depression. It also considers some of the determinants of depression, such as stress, trauma, life events, and biological factors such as genetics, brain mechanisms, hormones, and resilience. Finally, it describes treatment options for childhood and adolescent depression.