Is Childhood Bipolar Disorder Overdiagnosed?
Doctor Ellen Leibenluft discusses the question of over-diagnosis in childhood bipolar disorder, which may be caused by a gap in diagnostic ctiteria.
I wouldnâ€™t use the term over-diagnosis here in this particular instance because over-diagnosis implies that you are taking a healthy child and giving them a label, giving them a diagnosis, and that clearly is not whatâ€™s going on. The question is more whether itâ€™s the correct diagnosis that theyâ€™re getting. It appears that one of the problems is that they may not fit very well into the current diagnostic system. There isnâ€™t a good home for them in the current diagnostic system. The current diagnostic system is called the DSM IV. In that system, these very, very irritable children tend to also have ADHD (attention-deficit/hyperactivity disorder) so theyâ€™d get that diagnosis, they oppositional-defiant disorder. If you recruit them, and weâ€™ve recruited about 100 of them, they have very high rates of anxiety disorder, about a quarter of them have had an episode of depression by the time that they are 12. So they meet criteria for a lot of different diagnoses but there is no one diagnosis which really captures what they have. One could in a sense say that theyâ€™re being mis-diagnosed but that also isnâ€™t really fair because itâ€™s not like there is a clear diagnosis for them. The issue really is that there are these children out there that are very impaired, psychiatrically are having a great deal of difficulty but there isnâ€™t a diagnosis which captures very well exactly whatâ€™s happening with them. Well we donâ€™t know exactly whatâ€™s going to happen with these children in DSM V, and the process is really just beginning and people are talking about it. Certainly it is clear that thereâ€™s a problem here; that these very, very irritable children are not well served by the current diagnostic system in the DSM IV. Everyone is very aware of that, is talking about it and wants to do something to improve it; exactly what that will look like, people really need to talk about it more and review the data more before we can really come to any firm conclusions.
bipolar, disorder, diagnosis, dsm iv, attention deficit hyperactivity disorder, adhd, anxiety defiant disorder, depression, ellen, leibenluft
Professor Pat Levitt discusses that although it shares genes with other disorders, schizophrenia is likely caused by unique combinations of genes.
Doctor Ellen Leibenluft discusses possible reasons for the dramatic increase in the rates of diagnosis in childhood bipolar disorder in the past decade.
Doctor Ellen Liebenluft explains that individuals with bipolar disorder can spend some time in a normal mood, which is called euthymia.
Doctor Ellen Leibenluft explains that women and men are equally likely to develop bipolar disorder. Women are, however, more likely to develop the disorder after giving birth.
Doctor Ellen Leibenluft discusses recent research into childhood bipolar disorder, which is most commonly found in children with a family history of the disorder.
Professor Philip Shaw discusses research into ADHD diagnosis, which suggests the disorder is under- rather than over-diagnosed.
Professor Philip Shaw discusses similarities between ADHD, oppositional defiant disorder, and conduct disorder. The boundary between these disorders is somewhat unclear.
Doctor Ellen Leibenluft discusses the similarities between schizophrenia and bipolar disorder, which have some genetic risk factors in common.
Professor Philip Shaw rebuffs the myth that ADHD is not a serious disorder.
Doctor Ellen Leibenluft describes how environmental stressors such as grief and sleep-disturbance can precipitate bipolar disorder.