Update on Bipolar Disorder Controversy: Are American Docs Over-diagnosing?

American doctors are increasingly diagnosing and treating bipolar disease in children as young as 2 years old. In fact, Columbia University researchers found that the diagnosis of childhood bipolar disorder increased by 40 times between 1994 and 2004 – from 20,000 children to more than 800,000 in 2004. Meanwhile, European doctors are questioning whether such diagnoses are valid.

Last year, 73 British and 85 American doctors participated in a study in which they reviewed five case studies of mentally ill children under age 14. While the American doctors tended to diagnose bipolar disorder with mania, the British were more likely to label the behaviors adjustment or developmental disorders.

One problem in diagnosing bipolar disorder in children is that the classic symptom of mania or elevated mood states is often missing. For example, in one study of 1,700 children in Oregon, researchers identified only two cases that met the classic definition of mania alternating with depression and 16 cases diagnosed under broader criteria.

Those arguing in favor of diagnosing and treating bipolar disorder point to all the young children who are subject to rage and violent moods that baffle their parents. These children often respond well to medications used to treat bipolar disorder. If left untreated, their symptoms may only worsen and become debilitating when they go through adolescence.