Several months ago when I heard the news that Harvard Medical School and Massachusetts General Hospital punished three psychiatrists for not reporting pharma payments they’d pocketed, I thought it was just another story about conflict-of-interest violations. But as the controversy unfolded, I learned there was more to the story. All three physicians were well-known child psychiatrists. Two of the three were investigators and advocates for bipolar disorder diagnoses in children and adolescents, a condition called “pediatric bipolar disorder” that’s recently been more closely scrutinized.
The accusation that doctors and drug companies are in partnership to invent diseases and then push pills on the public to make a profit is not new. But when doctors are accused of cashing in by diagnosing children with nonexistent mental illness and then encouraging distraught parents to give their kids pharmaceuticals, well, that causes folks to stop and take a harder look.
According to a New York State Office of Mental Health news sheet, diagnoses of pediatric bipolar disorder (formerly called manic depressive disorder) are now 40 times more frequent than they were just 10 years ago. Shocked? Yeah, me too.
My main question is whether many of these diagnoses are accurate. According to the National Institute of Mental Health, it’s normal for almost every child or teen to exhibit some mood and behavioral changes listed as bipolar disorder symptoms. But often these symptoms are temporary and shouldn’t be confused with a brain disorder that requires drug treatment.
One reason for the increase in diagnoses of this condition, according to the Office of Mental Health, may be because the definition of the illness has been expanded to include anger and hyperactivity.
But are all angry, hyperactive kids bipolar? Clearly, that can’t be true. What some mental health professionals suggest is the need for reliable diagnoses—ones untainted by conflicts of interest, doctors’ greed or Big Pharma profit motives.
As the public becomes more receptive to mental health issues, what bears watching is how this heightened awareness of bipolar disorder in children works on behalf of kids living with the condition.
Sure, if doctors recognize children’s mental disorder symptoms early, they can diagnose and begin treatment sooner rather than later. But what should be avoided at all costs is doctors’ rush to prescribe heavy-duty, side-effects-loaded bipolar disorder meds for kids when other treatment options might be better.
When kids develop mental disorders, parents should be proactive and educate themselves to act as advocates for their children. Doctors should also share information and answer parents’ questions; this will lay a foundation of trust before they offer treatment recommendations for young patients.
Certainly, on one hand, I think it’s a good thing for doctors to recognize when children may have a mental health disorder. But on the other hand, it’s equally important to know when they don’t.
Editor’s Letter - Fall 2011
Kid Stuff
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