Doctor Ellen Leibenluft discusses possible reasons for the dramatic increase in the rates of diagnosis in childhood bipolar disorder in the past decade.

Recent data indicate that the rates at which children are receiving the diagnosis of bipolar disorder have skyrocketed. One recent paper reported a 40-fold increase over the last 10 years or so in terms of the number of children getting that diagnosis in the community. The evidence indicates that there may be several things going on here. The first thing is that there is an increased recognition that bipolar disorder can occur in children. So, it is likely that a certain number of those children would not have been recognized as having bipolar disorder in the past but now are getting more accurately diagnosed. At the same time however, there is also some evidence that children who have very, very severe irritability, they don’t necessarily have these clear episodes of mania or depression that you would expect to see in someone with bipolar disorder. Instead, what they have is irritability that’s extremely severe and goes on for months or even years. Those children are now also in many settings being given the diagnosis of bipolar disorder. There is no question that these very, very irritable children are very ill. They in fact are as ill, as impaired as children with bipolar disorder. They require hospitalization as often, they require medication as often, and they have as much trouble in school and at home and with their peers as do children with bipolar disorder. So these very, very irritable children who are getting the disorder of bipolar disorder, they need treatment and what they have is quite severe. But whether or not we should think of it as bipolar disorder or perhaps as a form of very severe depression is a question that’s receiving a great deal of research at the current time.

bipolar, disorder, diagnosis, childhood, depression, irritability, hospitalization, medication, ellen, leibenluft