The diagnosis of bipolar disorder in children has skyrocketed since the criteria for diagnosis was broadened in the mid-1990s. Now, a growing number of experts are pushing for new diagnoses that more accurately reflect the behaviors of children with the diagnosis.
In a paper published in Child and Adolescent Psychiatry and Mental Health, researchers Erik Parens and Josephine Johnston pointed out the difficulty of diagnosing any psychiatric disorders in children. Frequently, children diagnosed with bipolar disorder show behaviors that aren’t aligned with the disease’s criteria. In fact, there’s debate about whether symptoms in children, especially the symptoms of mania, actually fit the bipolar diagnosis at all.
To that end, more researchers are supporting the addition of two new diagnoses to the DSM (the manual used by mental health professionals to diagnose mental disorders). They are Severe Mood Dysregulation (SMD) or Temper Dysregulation Disorder with Dysphoria (TDD). According to the Red Orbit story linked, Johnston said “Using new labels such as SMD or TDD reflects that physicians do not yet know exactly what is wrong with these children or how to treat it. Facing up to this uncertainty could lead to better treatment recommendations and more accurate long-term prognosis.”
There are concerns about the safety and effectiveness of the drugs used to treat the disorder in children, as well as worries that slapping the bipolar label on children can distract from addressing the family or social context of the disorder. Having different diagnoses could help lead to more research and eventually, better treatment.
Judith Warner addresses the issue of medicating kids with serious mental disorders in her latest book, “We’ve Got Issues: Children and Parents in the Age of Medication”. Check out an awesome interview with her here.