The diagnosis of pediatric Bipolar Disorder (BD) is controversial; the prescription of antidepressants to increasing numbers of diagnosed children as young as four even more so. Many doctors are reluctant to diagnose or even recognize the disease before adulthood, most of the diagnosis criteria having been based on studies of adults.
Expanding research, however, aims to better define the disorder and to differentiate it from other mental health disorders. Today the National Institute of Mental Health (NIMH) released results of such a study, focusing on pediatric BD and another syndrome called severe mood dysregulation (SMD).
The two disorders share the symptom of chronic irritability. However, when researchers observed children with the disorders in frustrating situations, electroencephalograms (EEGs) revealed different brain mechanisms led to irritability in children with pediatric BD versus those with SMD. These findings counter assertions that the definition of pediatric BD be widened to include SMD and provide evidence that this sort of irritability alone is not enough to inform a diagnosis of bipolar disorder.
An editorial in the February 2007 issue of the American Journal of Psychology in which the study is published comments upon the findings, noting that while the experiment used chronic irritability as the bipolar phenotype, episodic irritability would have been more appropriate. The editorial further closes on sober advice, suggesting that, as they await further research on childhood bipolar disorder, doctors continue "to focus on diagnosis and then to seek proven treatments, rather than to engage in a simplistic and potentially risky symptom-ameliorating polypharmacy."
Press Release: Extreme Irritability: Is It Childhood Bipolar Disorder?
INTERVIEW: Dr. John McCellan discusses Kids & Bipolar Disorder
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