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Paediatric bipolar disorder: international comparisons of hospital discharge rates 2000–2010

Published online by Cambridge University Press:  02 January 2018

Joe Clacey
Affiliation:
Highfield Unit, Warneford Hospital, Oxford
Michael Goldacre
Affiliation:
Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Anthony James*
Affiliation:
Department of Psychiatry, University of Oxford, and Highfield Unit, Warneford Hospital, Oxford, UK
*
Anthony James, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. Email: anthony.james@psych.ox.ac.uk
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Abstract

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Background

Controversy surrounds the diagnosis and prevalence of paediatric bipolar disorder, with estimates varying considerably between countries.

Aims

To determine the international hospital discharge rates for paediatric bipolar disorder compared with all other psychiatric diagnoses.

Method

We used national data-sets from 2000 to 2010 from England, Australia, New Zealand, the USA and Germany.

Results

For those aged under 20 years, the discharge rates for paediatric bipolar disorder per 100 000 population were: USA 95.6, Australia 11.7, New Zealand 6.3, Germany 1.5 and England 0.9. The most marked divergence in discharge rates was in 5- to 9-year-olds: USA 27, New Zealand 0.22, Australia 0.14, Germany 0.03 and England 0.00.

Conclusions

The disparity between US and other discharge rates for paediatric bipolar disorder is markedly greater than the variation for child psychiatric discharge rates overall, and for adult rates of bipolar disorder. This suggests there may be differing diagnostic practices for paediatric bipolar disorder in the USA.

Type
Research Article
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2015

Footnotes

Declaration of interest

None.

References

1 Carlson, GA, Meyer, SE. Phenomenology and diagnosis of bipolar disorder in children, adolescents, and adults: complexities and developmental issues. Dev Psychopathol 2006; 18: 939–69.CrossRefGoogle ScholarPubMed
2 Biederman, J, Mick, E, Faraone, SV, Spencer, T, Wilens, TE, Wozniak, J. Pediatric mania: a developmental subtype of bipolar disorder? Biol Psychiatry 2000; 48: 458–66.CrossRefGoogle Scholar
3 Van Meter, AR, Moreira, AL, Youngstrom, EA. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry 2011; 72: 1250–6.CrossRefGoogle ScholarPubMed
4 Costello, EJ, Angold, A, Burns, BJ, Stangl, DK, Tweed, DL, Erkanli, A, et al. The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders. Arch Gen Psychiatry 1996; 53: 1129–36.CrossRefGoogle ScholarPubMed
5 Stringaris, A, Baroni, A, Haimm, C, Brotman, M, Lowe, CH, Myers, F, et al. Pediatric bipolar disorder versus severe mood dysregulation: risk for manic episodes on follow-up. J Am Acad Child Adolesc Psychiatry 2010; 49: 397405.Google ScholarPubMed
6 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; 64: 1032–9.CrossRefGoogle ScholarPubMed
7 Blader, JC, Carlson, GA. Increased rates of bipolar disorder diagnoses among U.S. child, adolescent, and adult inpatients, 1996–2004. Biol Psychiatry 2007; 62: 107–14.CrossRefGoogle ScholarPubMed
8 James, A, Hoang, U, Seagroatt, V, Clacey, J, Goldacre, M, Leibenluft, E. A comparison of American and English hospital discharge rates for pediatric bipolar disorder, 2000 to 2010. J Am Acad Child Adolesc Psychiatry 2014; 53: 614–24.CrossRefGoogle ScholarPubMed
9 Thomsen, PH, Moller, LL, Dehlholm, B, Brask, BH. Manic-depressive psychosis in children younger than 15 years: a register-based investigation of 39 cases in Denmark. Acta Psychiatr Scand 1992; 85: 401–6.CrossRefGoogle Scholar
10 Reddy, YC, Girimaji, S, Srinath, S. Clinical profile of mania in children and adolescents from the Indian subcontinent. Can J Psychiatry 1997; 42: 841–6.CrossRefGoogle ScholarPubMed
11 Rasanen, P, Tiihonen, J, Hakko, H. The incidence and onset-age of hospitalized bipolar affective disorder in Finland. J Affect Disord 1998; 48:63–8.CrossRefGoogle ScholarPubMed
12 Holtmann, M, Duketis, E, Poustka, L, Zepf, FD, Poustka, F, Bolte, S. Bipolar disorder in children and adolescents in Germany: national trends in the rates of inpatients, 2000–2007. Bipolar Disord 2010; 12: 155–63.CrossRefGoogle ScholarPubMed
13 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. WHO, 1993.Google Scholar
14 World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD–9). WHO, 1978.Google Scholar
15 World Health Organization. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). WHO, 2009.Google Scholar
16 National Casemix and Classification Centre. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) (8th edn). NCC, 2013.Google Scholar
17 Berry, G, Armitage, P. Mid-P confidence intervals: a brief review. Stat 1995; 44: 417–23.Google Scholar
18 Crow, E, Gardener, RS. Confidence interval for the expectation of a Poisson variable. Biometrika 1959; 46: 441–53.CrossRefGoogle Scholar
19 Wennberg, J. Forty years of unwarranted variation–and still counting. Health Policy 114: 12.CrossRefGoogle Scholar
20 The Dartmouth Institute for Health Policy and Clinical Practice. The Dartmouth Atlas of Health Care. The Dartmouth Institute for Health Policy and Clinical Practice, 2015. Available at: http://www.dartmouthatlas.org/.Google Scholar
21 American Psychiatric Association. Diagnostic and Statistical Manual of mental Disorders, 5th edn 5th edn (DSM-5). APA, 2013.Google Scholar
22 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). 1994.Google Scholar
23 National Institute of Clinical Excellence. Bipolar Disorder: The Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care. NICE, 2014.Google Scholar
24 Wozniak, J, Biederman, J. Childhood mania: insights into diagnostic and treatment issues. J Assoc Acad Minor Phys 1997; 8: 7884.Google ScholarPubMed
25 Geller, B, Tillman, R, Bolhofner, K, Zimerman, B. Child bipolar i disorder: prospective continuity with adult bipolar I disorder; characteristics of second and third episodes; predictors of 8-year outcome. Arch Gen Psychiatry 2008; 65: 1125–33.CrossRefGoogle ScholarPubMed
26 Sobanski, E, Banaschewski, T, Asherson, P, Buitelaar, J, Chen, W, Franke, B, et al. Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence. J Child Psychol Psychiatry 2010; 51: 915–23.CrossRefGoogle ScholarPubMed
27 Dubicka, B, Carlson, GA, Vail, A, Harrington, R. Prepubertal mania: diagnostic differences between US and UK clinicians. Eur Child Adolesc Psychiatry 2008; 17: 153–61.CrossRefGoogle ScholarPubMed
28 Mackin, P, Targum, SD, Kalali, A, Rom, D, Young, AH. Culture and assessment of manic symptoms. Br J Psychiatry 2006; 189: 379–80.CrossRefGoogle ScholarPubMed
29 Parry, PI, Levin, EC. Pediatric bipolar disorder in an era of “mindless psychiatry”. J Trauma Dissociation 2012; 13: 5168.CrossRefGoogle Scholar
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