Double Check Your Child's Mental Health Diagnosis!! Relationship expert Dr. Molly Barrow
"For example, in a study conducted in 2001,
nearly one-half of bipolar diagnoses in adolescent inpatients made by
community clinicians were later re-classified as other mental disorders."
WHAT!!! The poor kids....
Remember when doctors were giving women a lobotomy when they were frustrated with housework? And how many women had unnecessary Cesareans and hysterectomies in the fifties and sixties? Well, women have wised up. They are taking more control of their health and acting more cautiously when it comes to surgery. So, what is a multi-billion dollar business to do?
Are you aware that your doctor is inundated with appointments and phone calls to introduce them to the latest medication. Caught in the hallway, a doctor is handed boxes of free samples to experiment with - on himself or his patients and a quick summary of questionable clinical studies...an interpretation in only a few moments by attractive salespersons (usually) women. Most doctors want to sincerely help their patients. But they must also stay on top in the competitive fight for the consumer's dollar. A doctor is after all a business just like Walmart and McDonald's.
According to studies by Columbia University and National Institute for Mental Health drug companies and doctors may have discovered a brand new market? Our children! Read this alarming report by Marcus Zillman.
RATES OF BIPOLAR DIAGNOSIS IN YOUTH RAPIDLY CLIMBING, TREATMENT PATTERNS
SIMILAR TO ADULTS
The number of visits to a doctor's office that resulted in a diagnosis of
bipolar disorder in children and adolescents has increased by 40 times
over the last decade, reported researchers funded in part by the National
Institutes of Health (NIH). Over the same time period, the number of
visits by adults resulting in a bipolar disorder diagnosis almost doubled.
The cause of these increases is unclear. Medication prescription patterns
for the two groups were similar. The study was published in the September
2007 issue of the "Archives of General Psychiatry".
Mark Olfson, M.D., M.P.H., of New York State Psychiatric Institute of
Columbia University, along with National Institute of Mental Health (NIMH)
researcher Gonzalo Laje, M.D., and their colleagues examined 10 years of
data from the National Ambulatory Medical Care Survey (NAMCS), an annual,
nationwide survey of visits to doctors' offices over a one-week period,
conducted by the National Center for Health Statistics. The researchers
estimated that in the United States from 1994-1995, the number of office
visits resulting in a diagnosis of bipolar disorder
for youths ages 19 and younger was 25 out of every 100,000 people. By
2002-2003, the number had jumped to 1,003 office visits resulting in
bipolar diagnoses per 100,000 people. In contrast, for adults ages 20 and
older, 905 office visits per 100,000 people resulted in a bipolar disorder
diagnosis in 1994-1995; a decade later the number had risen to 1,679 per
100,000 people.
While the increase in bipolar diagnoses in youth far outpaces the increase
in diagnosis among adults, the researchers are cautious about interpreting
these data as an actual rise in the number of people who have the illness
(prevalence) or the number of new cases each year (incidence).
"It is likely that this impressive increase reflects a recent tendency to
overdiagnose bipolar disorder in young people, a correction of historical
under recognition, or a combination of these trends. Clearly, we need to
learn more about what criteria physicians in the community are actually
using to diagnose bipolar disorder in children and adolescents and how
physicians are arriving at decisions concerning clinical management," said
Dr. Olfson.
The fourth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV) provides general guidelines that can help doctors
identify bipolar disorder in young patients. However, some studies show
that youths with symptoms of mania (over-excited, elated mood) -- one of
the classic signs of bipolar disorder -- often do not meet the full
criteria for a diagnosis of bipolar disorder. Other disorders, such as
attention-deficit hyperactivity disorder (ADHD)
, may have
symptoms that overlap, so some of these conditions may be mistaken for
bipolar disorder as well. For example, in a study conducted in 2001,
nearly one-half of bipolar diagnoses in adolescent inpatients made by
community clinicians were later re-classified as other mental disorders.
Doctors also face tough questions when deciding on proper treatment for
young people. Guidelines for treating adults with bipolar disorder are
well-documented by research, but few studies have looked at the safety and
effectiveness of psychiatric medications for treating children and
adolescents with the disorder. Despite this limited evidence, the
researchers found similar treatment patterns for both age groups in terms
of use of psychotherapy and prescription medications.
Of the medications studied, mood stabilizers, including lithium -- which
was the only medication approved at the time of the study by the U.S. Food
and Drug Administration for treating bipolar disorder in children -- were
prescribed in two-thirds of the visits by youth and adults. Anticonvulsant
medications, such as valproate (Depakote) and carbamazepine (Tegretol),
were the most frequently prescribed type of mood stabilizers in both
groups.
Doctors prescribed antidepressant medications in slightly over one-third
of visits by youth and adults. Antidepressant medications include the
older classes of antidepressant medications, such as tricyclics,
tetracyclics, and monoamine oxidase inhibitors (MAOIs); selective
serontonin reuptake inhibitors, such as fluoxetine (Prozac) and paroxetine
(Paxil); and also newer types of antidepressants, including venlafaxine
(Effexor). In both age groups, about one-third of the visits where
antidepressant medications were prescribed did not include prescription of
a mood stabilizer. This trend raises concerns, considering an earlier
NIMH-funded study (Thase & Sachs, 2000) which reported that treating
adults who have bipolar disorder with an antidepressant in the absence of
a mood stabilizer may put them at risk of switching to mania. Also, a
recent NIMH study showed that for depressed adults with bipolar disorder
who are taking a mood stabilizer, adding an antidepressant medication
was no more effective in managing bipolar symptoms
than a placebo (sugar pill).
Roughly the same percentage of youth and adult bipolar visits included a
prescription for an antipsychotic medication, although young patients were
more likely to be prescribed one of the newer, atypical antipsychotic
medications, such as aripiprazole (Abilify) or olanzapine (Zyprexa), than
other types of antipsychotics. This finding suggests that doctors may be
basing their treatment choices for bipolar youth on prescribing practices
for adults with the disorder.
However, one main difference between youth and adult treatment was that
children and teens were more likely than adults to be prescribed a
stimulant medication -- usually prescribed for treating ADHD -- and adults
were more likely than youth to be prescribed benzodiazepines, a type of
medication used to treat anxiety disorders
More than half of all diagnosed youths and adults were prescribed a
combination of medications. Given the relative lack of studies on
appropriate treatments for youth with bipolar disorder, the researchers
noted the urgent need for more research on the safety and effectiveness of
medication treatments that are commonly prescribed to this age group.
The study had several important limitations. For example, the survey
relied on the judgment of the treating physicians, rather than an
independent assessment. As a result, the researchers' findings reveal more
about patterns in diagnosis among office-based doctors than about
definitive numbers of people affected by the illness. Another limitation
is that the survey recorded the number of office visits instead of the
number of individual patients, so some people may have been counted more
than once.
"A forty-fold increase in the diagnosis of bipolar disorder in children
and adolescents is worrisome," said NIMH Director Thomas R. Insel, M.D.
"We do not know how much of this increase reflects earlier underdiagnosis,
current overdiagnosis, possibly a true increase in prevalence of this
illness, or some combination of these factors. However, these new results
confirm what we are hearing increasingly from families who tell us about
disabling, sometimes dangerous psychiatric symptoms in their children.
This report reminds us of the need for research that validates the
diagnosis of bipolar disorder and other disorders in children and the
importance of developing treatments that are safe, effective, and feasible
for use in primary care."
"This research, performed at a National Center on Minority Health and
Health Disparities Center of Excellence, underscores the need to fully
engage the community with their health care providers to better understand
the actual prevalence of bipolar disease in children and adolescents,"
said John Ruffin, Ph.D., Director of NCMHD.
Additional study authors were Carmen Moreno, M.D., and Carlos Blanco,
M.D., Ph.D., of New York State Psychiatric Institute/College of Physicians
and Surgeons of Columbia University; Andrew B. Schmidt, C.S.W., of New
York State Psychiatric Institute; and Huiping Jiang, Ph.D., of Columbia
University.
The study was funded by the NIMH Intramural Research Program, National
Institute on Drug Abuse (NIDA), NCMHD, the Agency for Healthcare Research
and Quality (AHRQ), the Alicia Koplowitz Foundation, and the New York
State Psychiatric Institute.
Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M. National trends
in the outpatient diagnosis and treatment of bipolar disorder in youth.
"Arch Gen Psychiatry". 2007 Sep;64(9).
The National Institute of Mental Health (NIMH) mission is to reduce the
burden of mental and behavioral disorders through research on mind, brain,
and behavior. More information is available at the NIMH website
The National Institute of Environmental Health Sciences (NIEHS), a
component of the National Institutes of Health, supports research to
understand the effects of the environment on human health. For more
information on environmental health topics, please visit our website at
The National Institutes of Health (NIH) -- The Nation's Medical Research
Agency -- includes 27 Institutes and Centers and is a component of the U.
S. Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical, and translational
medical research, and it investigates the causes, treatments, and cures
for both common and rare diseases. For more information about NIH and its
programs, visit
Marcus P. Zillman, M.S., A.M.H.A.
Internet Expert, Tutor, Author, Keynote Speaker and Corporate Consultant
Executive Director - Virtual Private Library�
http://www.VirtualPrivateLibrary.org/
http://www.Zillman.us/
http://www.zillman.info/
http://www.WhitePapers.us/
eVoice: 800-858-1462
eFax: 305-425-0920
nearly one-half of bipolar diagnoses in adolescent inpatients made by
community clinicians were later re-classified as other mental disorders."
WHAT!!! The poor kids....
Remember when doctors were giving women a lobotomy when they were frustrated with housework? And how many women had unnecessary Cesareans and hysterectomies in the fifties and sixties? Well, women have wised up. They are taking more control of their health and acting more cautiously when it comes to surgery. So, what is a multi-billion dollar business to do?
Are you aware that your doctor is inundated with appointments and phone calls to introduce them to the latest medication. Caught in the hallway, a doctor is handed boxes of free samples to experiment with - on himself or his patients and a quick summary of questionable clinical studies...an interpretation in only a few moments by attractive salespersons (usually) women. Most doctors want to sincerely help their patients. But they must also stay on top in the competitive fight for the consumer's dollar. A doctor is after all a business just like Walmart and McDonald's.
According to studies by Columbia University and National Institute for Mental Health drug companies and doctors may have discovered a brand new market? Our children! Read this alarming report by Marcus Zillman.
RATES OF BIPOLAR DIAGNOSIS IN YOUTH RAPIDLY CLIMBING, TREATMENT PATTERNS
SIMILAR TO ADULTS
The number of visits to a doctor's office that resulted in a diagnosis of
bipolar disorder in children and adolescents has increased by 40 times
over the last decade, reported researchers funded in part by the National
Institutes of Health (NIH). Over the same time period, the number of
visits by adults resulting in a bipolar disorder diagnosis almost doubled.
The cause of these increases is unclear. Medication prescription patterns
for the two groups were similar. The study was published in the September
2007 issue of the "Archives of General Psychiatry".
Mark Olfson, M.D., M.P.H., of New York State Psychiatric Institute of
Columbia University, along with National Institute of Mental Health (NIMH)
researcher Gonzalo Laje, M.D., and their colleagues examined 10 years of
data from the National Ambulatory Medical Care Survey (NAMCS), an annual,
nationwide survey of visits to doctors' offices over a one-week period,
conducted by the National Center for Health Statistics. The researchers
estimated that in the United States from 1994-1995, the number of office
visits resulting in a diagnosis of bipolar disorder
for youths ages 19 and younger was 25 out of every 100,000 people. By
2002-2003, the number had jumped to 1,003 office visits resulting in
bipolar diagnoses per 100,000 people. In contrast, for adults ages 20 and
older, 905 office visits per 100,000 people resulted in a bipolar disorder
diagnosis in 1994-1995; a decade later the number had risen to 1,679 per
100,000 people.
While the increase in bipolar diagnoses in youth far outpaces the increase
in diagnosis among adults, the researchers are cautious about interpreting
these data as an actual rise in the number of people who have the illness
(prevalence) or the number of new cases each year (incidence).
"It is likely that this impressive increase reflects a recent tendency to
overdiagnose bipolar disorder in young people, a correction of historical
under recognition, or a combination of these trends. Clearly, we need to
learn more about what criteria physicians in the community are actually
using to diagnose bipolar disorder in children and adolescents and how
physicians are arriving at decisions concerning clinical management," said
Dr. Olfson.
The fourth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV) provides general guidelines that can help doctors
identify bipolar disorder in young patients. However, some studies show
that youths with symptoms of mania (over-excited, elated mood) -- one of
the classic signs of bipolar disorder -- often do not meet the full
criteria for a diagnosis of bipolar disorder. Other disorders, such as
attention-deficit hyperactivity disorder (ADHD)
symptoms that overlap, so some of these conditions may be mistaken for
bipolar disorder as well. For example, in a study conducted in 2001,
nearly one-half of bipolar diagnoses in adolescent inpatients made by
community clinicians were later re-classified as other mental disorders.
Doctors also face tough questions when deciding on proper treatment for
young people. Guidelines for treating adults with bipolar disorder are
well-documented by research, but few studies have looked at the safety and
effectiveness of psychiatric medications for treating children and
adolescents with the disorder. Despite this limited evidence, the
researchers found similar treatment patterns for both age groups in terms
of use of psychotherapy and prescription medications.
Of the medications studied, mood stabilizers, including lithium -- which
was the only medication approved at the time of the study by the U.S. Food
and Drug Administration for treating bipolar disorder in children -- were
prescribed in two-thirds of the visits by youth and adults. Anticonvulsant
medications, such as valproate (Depakote) and carbamazepine (Tegretol),
were the most frequently prescribed type of mood stabilizers in both
groups.
Doctors prescribed antidepressant medications in slightly over one-third
of visits by youth and adults. Antidepressant medications include the
older classes of antidepressant medications, such as tricyclics,
tetracyclics, and monoamine oxidase inhibitors (MAOIs); selective
serontonin reuptake inhibitors, such as fluoxetine (Prozac) and paroxetine
(Paxil); and also newer types of antidepressants, including venlafaxine
(Effexor). In both age groups, about one-third of the visits where
antidepressant medications were prescribed did not include prescription of
a mood stabilizer. This trend raises concerns, considering an earlier
NIMH-funded study (Thase & Sachs, 2000) which reported that treating
adults who have bipolar disorder with an antidepressant in the absence of
a mood stabilizer may put them at risk of switching to mania. Also, a
recent NIMH study showed that for depressed adults with bipolar disorder
who are taking a mood stabilizer, adding an antidepressant medication
was no more effective in managing bipolar symptoms
than a placebo (sugar pill).
Roughly the same percentage of youth and adult bipolar visits included a
prescription for an antipsychotic medication, although young patients were
more likely to be prescribed one of the newer, atypical antipsychotic
medications, such as aripiprazole (Abilify) or olanzapine (Zyprexa), than
other types of antipsychotics. This finding suggests that doctors may be
basing their treatment choices for bipolar youth on prescribing practices
for adults with the disorder.
However, one main difference between youth and adult treatment was that
children and teens were more likely than adults to be prescribed a
stimulant medication -- usually prescribed for treating ADHD -- and adults
were more likely than youth to be prescribed benzodiazepines, a type of
medication used to treat anxiety disorders
More than half of all diagnosed youths and adults were prescribed a
combination of medications. Given the relative lack of studies on
appropriate treatments for youth with bipolar disorder, the researchers
noted the urgent need for more research on the safety and effectiveness of
medication treatments that are commonly prescribed to this age group.
The study had several important limitations. For example, the survey
relied on the judgment of the treating physicians, rather than an
independent assessment. As a result, the researchers' findings reveal more
about patterns in diagnosis among office-based doctors than about
definitive numbers of people affected by the illness. Another limitation
is that the survey recorded the number of office visits instead of the
number of individual patients, so some people may have been counted more
than once.
"A forty-fold increase in the diagnosis of bipolar disorder in children
and adolescents is worrisome," said NIMH Director Thomas R. Insel, M.D.
"We do not know how much of this increase reflects earlier underdiagnosis,
current overdiagnosis, possibly a true increase in prevalence of this
illness, or some combination of these factors. However, these new results
confirm what we are hearing increasingly from families who tell us about
disabling, sometimes dangerous psychiatric symptoms in their children.
This report reminds us of the need for research that validates the
diagnosis of bipolar disorder and other disorders in children and the
importance of developing treatments that are safe, effective, and feasible
for use in primary care."
"This research, performed at a National Center on Minority Health and
Health Disparities Center of Excellence, underscores the need to fully
engage the community with their health care providers to better understand
the actual prevalence of bipolar disease in children and adolescents,"
said John Ruffin, Ph.D., Director of NCMHD.
Additional study authors were Carmen Moreno, M.D., and Carlos Blanco,
M.D., Ph.D., of New York State Psychiatric Institute/College of Physicians
and Surgeons of Columbia University; Andrew B. Schmidt, C.S.W., of New
York State Psychiatric Institute; and Huiping Jiang, Ph.D., of Columbia
University.
The study was funded by the NIMH Intramural Research Program, National
Institute on Drug Abuse (NIDA), NCMHD, the Agency for Healthcare Research
and Quality (AHRQ), the Alicia Koplowitz Foundation, and the New York
State Psychiatric Institute.
Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M. National trends
in the outpatient diagnosis and treatment of bipolar disorder in youth.
"Arch Gen Psychiatry". 2007 Sep;64(9).
The National Institute of Mental Health (NIMH) mission is to reduce the
burden of mental and behavioral disorders through research on mind, brain,
and behavior. More information is available at the NIMH website
The National Institute of Environmental Health Sciences (NIEHS), a
component of the National Institutes of Health, supports research to
understand the effects of the environment on human health. For more
information on environmental health topics, please visit our website at
The National Institutes of Health (NIH) -- The Nation's Medical Research
Agency -- includes 27 Institutes and Centers and is a component of the U.
S. Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical, and translational
medical research, and it investigates the causes, treatments, and cures
for both common and rare diseases. For more information about NIH and its
programs, visit
Marcus P. Zillman, M.S., A.M.H.A.
Internet Expert, Tutor, Author, Keynote Speaker and Corporate Consultant
Executive Director - Virtual Private Library�
http://www.VirtualPrivateLibrary.org/
http://www.Zillman.us/
http://www.zillman.info/
http://www.WhitePapers.us/
eVoice: 800-858-1462
eFax: 305-425-0920
posted by Dr. Molly @ 12:30 PM
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