Rapid rise in bipolar diagnoses among youth

NEW YORK (Reuters Health) - The number of young Americans diagnosed with bipolar disorder has risen dramatically in recent years, according to a new study.

This increase highlights the need for "reliability studies" to determine the accuracy of diagnoses of child and adolescent bipolar disorder, conclude the researchers in a report in the latest issue of the Archives of General Psychiatry.

Bipolar disorder is a psychiatric illness that typically involves periods of mania (abnormally elevated mood) and depression.

Dr. Mark Olfson, from Columbia University, New York and New York State Psychiatric Institute, and colleagues compared increases between 1994-1995 and 2002-2003 in office visits that culminated in a diagnosis of bipolar disorder among individuals aged 19 and younger to that among adults aged 30 and older.

They found that outpatient visits with a diagnosis of bipolar disorder in the younger age group increased approximately 40-fold, from 25 per 100,000 in 1994-1995 to 1,003 per 100,000 population in 2002-2003. During the same time, the diagnosis of bipolar disorder in adults increased nearly 2-fold, from 905 to 1,679 per 100,000.

There are two possible reasons for the "impressive increase" in cases of bipolar disorder in young people, the authors say. Either bipolar disorder was historically under diagnosed in children and adolescents and the problem has now been rectified or bipolar disorder is currently being over diagnosed in this age group.

"Without independent systematic diagnostic assessments, we cannot confidently select between these competing hypotheses," they note.

Olfson's team also found that the vast majority of youth and adults were prescribed a psychotropic drug at the time of diagnosis of bipolar disorder, including mood stabilizers, antipsychotics and antidepressants.

"There is an urgent need," the researchers warn, to evaluate the effectiveness and safety of drugs commonly used to treat young people diagnosed with bipolar disorder.

SOURCE: Archives of General Psychiatry, September 2007.