Debate Editorial: Very early onset bipolar disorder – international differences in prevalence, practice or language?

Carlson, Gabrielle A.; Dubicka, Bernadka

doi:10.1111/camh.12315

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…[R]ates of mania/bipolar I disorder are lower in both places than referenced by Van Meter, et al Van Meter and colleagues responded to our reanalysis, which prompted a nine-article debate section in CAMH (Carlson and Dubicka 2019;Duffy 2019;Goldstein et al 2019;Hazell 2019;Hillegers 2019;Pan et al 2019;Parry et al 2019a;Stringaris 2019;Van Meter et al 2019b). Duffy, lead researcher for the longitudinal Canadian high-risk offspring study, summarised research data and concluded (Duffy 2019):…”

Section: Prior Re-examination Of First Meta-analysis Of 'Pbd' Communi...mentioning

confidence: 89%

‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis

Parry

Allison

Bastiampillai

2021

Int J Bipolar Disord

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Background ‘Pediatric bipolar disorder’ (PBD) is a controversial diagnosis with varying rates of clinical diagnosis. A highly cited meta-analysis (Van Meter et al. 2011) of a dozen epidemiological surveys suggested a global community prevalence of PBD of 1.8%. This was updated to 3.9% with eight additional surveys (Van Meter et al. 2019a). In terms of the Cochrane Handbook for Systematic Reviews of Interventions, the heterogenous community surveys were arguably unsuitable for statistical meta-analysis and warranted a narrative analysis. A narrative analysis (Parry et al. 2018) of the original 12 surveys concluded rates of PBD were substantially lower than 1.8% and led to a nine-article debate on the validity, arguable overdiagnosis and iatrogenic aspects of the PBD diagnosis (e.g. Carlson and Dubicka Child Adolesc Mental Health 21:86–87, 2019). This article extends the narrative analysis to include the eight newer community surveys. Methods A narrative analysis of the methodologies and the prevalence rates reported by the epidemiological surveys. Results Across all twenty surveys there was significant variation in methodologies and reported prevalence rates. Of the eight newer surveys, five (two Brazilian, one English, one Turkish, one United States) provided information of pre-adolescent prevalence rates of bipolar spectrum disorder. These pre-adolescent rates were zero or close to zero. Rates of adolescent hypomania and mania were higher, but follow-up data in two studies suggested hypomania might sometimes achieve prolonged remission or not lead to adult bipolar disorder. Limitations Methods in the original surveys vary and criteria used for various bipolar diagnoses were not always fully described. This limitation applies to a narrative analysis but also to a statistical meta-analysis. Conclusion Bipolar disorder is very rare in childhood and rare in adolescence. PBD as a diagnostic construct fails to correlate with adult bipolar disorder and the term should be abandoned. Hypomanic syndromes in adolescence may not always progress to adult bipolar disorder. Early diagnosis of bipolar disorder is important, but over-diagnosis risks adverse iatrogenic consequences.

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Section: Prior Re-examination Of First Meta-analysis Of 'Pbd' Communi...mentioning

confidence: 89%

‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis

Parry

Allison

Bastiampillai

2021

Int J Bipolar Disord

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“…Further, studies have noted cross-cultural differences in diagnosis such that US psychiatrists conceptualize explosive temper, chronic behavioral and social and cognitive dysregulation/deficits as a form of bipolar disorder, while UK and EU psychiatrists preferential diagnose pervasive developmental disorder (not PBD). 49,50 On the other hand, one may argue that all included studies used validated diagnostic tools, such as the K-SADS, to categorize patient groups. Furthermore, we have previously shown that the diagnosis of PBD is stable over time.…”

Section: Limitations and Direction For Future Researchmentioning

confidence: 99%

Psychiatric comorbidity in patients with pediatric bipolar disorder – A systematic review

Fahrendorff

Pagsberg

Kessing

et al. 2023

Acta Psychiatr Scand

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Background: A growing body of evidence suggests that pediatric bipolar disorder (PBD) frequently co-occurs with comorbid psychiatric disorders that may impact functioning.Objective: To review existing literature on the prevalence of psychiatric comorbidity and general functioning in patients with a primary diagnosis of PBD. Methods:We performed a systematic literature search on the PubMed, Embase and PsycInfo databases on November 16th, 2022. We included original papers on patients ≤18 years with primary PBD and any comorbid psychiatric disorder, diagnosed according to a validated diagnostic tool. Risk of bias of the individual studies was assessed using the STROBE checklist. We calculated weighted means to assess the comorbidity prevalence. The review complied with PRISMA statement guidelines.Results: Twenty studies with a total study population of 2722 patients with PBD were included (mean age = 12.2 years). We found an overall high prevalence of comorbidity in patients with PBD. The most common comorbidities were attention-deficit-hyperactivity disorder (ADHD) (60%) and oppositional defiant disorder (ODD) (47%). Anxiety disorders, obsessive-compulsive disorder, conduct disorder, tic disorders and substance-related disorders affected between 13.2% and 29% of patients, while one in 10 had comorbid mental retardation or autism spectrum disorder (ASD). The prevalence of comorbid disorders was lower in studies that assessed the current prevalence in patients in full or partial remission. General functioning was overall not specifically decreased in patients with comorbidity. Conclusions: Comorbidity across a broad range of disorders was high in children diagnosed with PBD, especially regarding ADHD, ASD, behavioral and anxiety disorders including OCD. Future original studies should assess current prevalence of comorbidities in patients with PBD who are in remission to obtain more reliable estimates of psychiatric comorbidity in this patient group. The review highlights the clinical and scientific importance of comorbidity in PBD.

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“…Bipolar disorder is common in clinical psychiatric practice, and several studies have estimated its prevalence to range from 0.5 to 5% in community-based samples. (1) In South East Asia, the proportion of type I bipolar disorder is 0.6% and that of type II is 0.4%. (2) However, establishing the diagnosis in both children and adolescents is still challenging.…”

Section: Introductionmentioning

confidence: 99%

Bipolar disorder increases the risk of poor sleep quality among senior high school students

Hasan

Junardi

2020

Universa Medicina

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Background Patients with bipolar disorder commonly experience sleeping problems. On the other hand, sleep disturbances have been suggested as one of the symptoms that indicate the development of bipolar disorder. Considering the detrimental effect of bipolar disorder, especially in young people, this study aimed to determine the relationship between sleep quality and risk of bipolar disorder in senior high school students. Methods A cross-sectional study was conducted involving 725 senior high school students. The instruments used were a demographic questionnaire, Young Mania Rating Scale (YMRS), MINI International Neuropsychiatric Interview (MINI ICD-10), Hypomania/Mania Symptom Checklist (HCL-32), and Pittsburgh Sleep Quality Index (PSQI). Univariate and bivariate (simple logistic regression) analyses were performed to evaluate the relation between sleep quality and the risk of bipolar disorder. Results Around 28% of subjects were at risk of bipolar disorder, of which 96.6% were prone to type I, and the rest were type II. Most of the participants with bipolar disorder (64%) had poor sleep quality. The percentage of participants with type I bipolar disorder that had poor sleep quality was higher than that of type II (65.3% and 28.6%, respectively). There was a significant relationship between bipolar disorder and sleep quality (OR = 2.2; 95% CI=1.581-3.087; p=0.000). Conclusions Our study demonstrated that in senior high school students, bipolar disorder increased the risk of poor sleep quality. Assessment of sleep disturbances routinely in psychiatric interviews may improve sleep quality. Keywords: Bipolar disorder, sleep quality, senior high school student

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Debate Editorial: Very early onset bipolar disorder – international differences in prevalence, practice or language?

Abstract: Read the core debate at: doi: ; doi: ; doi: ; doi: Read more perspectives in this debate at: doi: doi: ; doi: ; doi: ; doi: ; doi:

Cited by 5 publications

References 7 publications

‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis

‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis

Psychiatric comorbidity in patients with pediatric bipolar disorder – A systematic review

Bipolar disorder increases the risk of poor sleep quality among senior high school students

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