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Bipolar Children Epidemic Or Rampant Misdiagnosis? DSM-5 Makes Some Changes

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First Posted: May 20, 2013 07:54 AM EDT
Students at Rose Hill Elementary School participate in a running race during physical education class in Commerce City, Colorado.

Students at Rose Hill Elementary School participate in a running race during physical education class in Commerce City, Colorado. Credit:Reuters

The new fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was recently launched at a press conference. Also known as the "bible" of psychiatry, several changes were made to the DSM-5 which sparked controversy before its release.

The manual provides definitions of all known mental illnesses and took over 10 years for 1,500 experts from around the world to revise. A new diagnosis called disruptive mood dysregulation disorder (DMDD) could change the way bipolar disorder in children is diagnosed. This new diagnosis provides a solution for the epidemic of many angry, irritable kids being wrongly diagnosed with bipolar disorder.

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DMDD would be used to diagnose children age 6 and over who repeatedly show severe outbursts of rage in addition to long periods of being angry and chronically irritable.

"We're not referring to the usual childhood temper tantrum," DSM-5 Task Force chairman from the University of Pittsburgh, David Kupfer said.

Three or more outbursts of rage per week over the course of one year is required for children to be diagnosed with DMDD.

Children under the age of 6 who are prone to throw frequent temper tantrums are excluded from DMDD diagnosis. As MedPage Today reported, the new diagnosis from the American Psychiatric Association "is intended, in part, to address issues about potential over-diagnosis and over-treatment of bipolar disorder, Kupfer said.

Newsweek reported in 2011 that bipolar disorder in children became somewhat of a trend among mental health professionals. Children were rarely diagnosed with bipolar disorder before 1995 and a significant increase occurred years later. The rise in diagnosis increased from 20,000 in 1994-1995 to 40 times that, at a reported 800,000 bipolar cases in children, in 2002- 2003.

The symptoms of bipolar disorder are also found in mania, attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Both ADHD and ODD are common in school age children and symptoms include irritability, distractibility, and talkativeness.

The new 947 page DSM-5 will be published on May 22 and also includes changes to the definitions of depression, dementia, adult ADHD and eating disorders.

 

 

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