In less than a decade, from roughly 1994 to 2003, the diagnosis and treatment of bipolar disorder in children and adolescents underwent a dramatic and unwarranted increase. Before 1995 bipolar disorder was rarely diagnosed in children and adolescents; today the diagnosis is commonplace, with a forty-fold increase in the number of outpatient visits for this diagnosis in childhood. In 1995 there were 20,000 such visits; by 2003 the yearly number was 800,000! Now, nearly one-third of all children and adolescents discharged from child psychiatric hospitals have been diagnosed with bipolar disorder. Most of these diagnoses are incorrect.
Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis examines this diagnostic fad through a variety of lenses. Author Stuart L. Kaplan, M.D., draws heavily on his forty years of experience as a clinician, researcher, and professor of child psychiatry, to make the argument that bipolar disorder in children and adolescents is incorrectly diagnosed and incorrectly treated.
As Dr. Kaplan explains, the dramatic rise in this particular diagnosis is not based on scientific evidence; it does not reflect any new discovery or insight about the etiology or treatment of the disorder. In fact, the opposite is the case: the scientific evidence against the existence of child bipolar disorder is so strong that it is difficult to imagine how it has gained the endorsement of anyone in the scientific community.
Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis explains to parents and professionals the faulty reasoning and bad science behind the misdiagnosis of childhood bipolar disorder. He critiques the National Institute of Mental Health, academic child psychiatry, the pharmaceutical industry, and the media for their respective roles in advocating for the adoption of this diagnosis.
Dr. Kaplan describes very clearly what the children and adolescents actually do have, and how it should be treated. He provides real-life clinical scenarios and describes approaches to treatment that work.
The book is divided into three parts. Part One: Critique of Pediatric Bipolar Disorder presents the arguments against the diagnosis. In chapter one, bipolar disorder is carefully described and the DSM-IV definition of the disorder is explained. In chapter two, pediatric bipolar is described as has it has been put forward by two leading advocates of the diagnosis in children. Numerous case examples are provided and the failure of the disorder to meet DSM criteria for the diagnosis is made undeniably clear. Some early published studies are reviewed briefly and critically to demonstrate the weakness of the evidence for the existence of the disorder. For example, the doctors who gave the children the diagnoses in some of these research studies did not even meet with or talk to the children. In chapter three, exceptionally interesting scientific areas are reviewed in an easily understood fashion. The genetics of the disorder are explained and follow up studies are considered. Chapter four reviews the role of the culture of science and the popular media in creating the diagnosis. Depression and bipolar disorder in adolescence are discussed in the last two chapters of Part One.
Medications are such an integral part of psychiatry and of the diagnosis and treatment of pediatric bipolar disorder that they are a given the entire second part of the book. Three medications commonly used in the treatment of pediatric bipolar disorder are considered in detail in chapter 7. Chapter 8 describes clinical drug studies in some detail to assist the reader in more fairly valuing the science of the study of medication in psychiatry. The poor behavior of the pharmaceutical industry is acknowledged as is their invaluable contribution to development of current treatments in psychiatry. Chapter 9 is titled Bad Science. It highlights and describes many of the improper methods noted throughout the book. Chapter 10 reviews the controversial issue of the use of stimulant medication in the treatment of pediatric bipolar disorder.
The third part of the book provides advice to parents about the use of medication and provides a detailed description of a behavior modification program that Dr. Kaplan has found to be useful in treating the problems shown by many of the children given the pediatric bipolar disorder diagnosis.
Click here for a the complete table of contents.