The diagnosis of bipolar disorder in children and adolescents has risen fortyfold since 1994, according to a study released Monday. But researchers partly attributed the dramatic rise to doctors overdiagnosing the serious psychiatric disorder.
The report in the journal Archives of General Psychiatry said bipolar disorder was found in 1,003 of every 100,000 office visits from children and adolescents in 2002-03, compared with 25 of 100,000 visits in 1994-95.
The diagnosis of bipolar disorder among adults increased twofold during the same period, researchers said.
The study did not investigate the reasons for the explosion in bipolar cases among children and adolescents that followed the 1998 publication of “The Bipolar Child,” which made the controversial assertion that one-third to one-half of children with depression had bipolar disorder.
Dr. Mark Olfson , a psychiatrist at Columbia University’s College of Physicians and Surgeons and senior author of the study, said part of the increase was attributable to an underdiagnosis of bipolar disorder in the past.
But Olfson said another reason was the mislabeling of children and adolescents with aggressive or irritable behaviors as bipolar, an illness that is treated with powerful psychotropic medications.
Dr. Thomas Insel , director of the National Institute of Mental Health, which funded the study, called the increase in bipolar diagnoses worrisome.
“The way the label is being used is probably a little exuberant — not fitting with the strict definition of the illness,” Insel said. The disorder “is probably not as common as the very high rates we’re seeing.”
Bipolar disorder is marked by severe mood swings between depression and mania, which is characterized by an excess of energy and restlessness.
For most patients, depressive episodes are three times more common and longer-lasting than those of mania.
Symptoms of the disorder can interfere with daily activities, and severe cases carry a risk of suicide.
