Reviews

Stuart Kaplan, M.D., has written a brilliant, scholarly, and long overdue book providing compelling evidence that what is often diagnosed as pediatric bipolar disorder is not true bipolar disorder. As explained by Dr. Kaplan, diagnostic criteria for bipolar disorder as specified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are clear and unambiguous. Individuals with bipolar disorder have discrete episodes of mania and depression and can go for months between episodes without symptoms. This is in sharp contrast to the chronic irritability, anger, explosiveness, moodiness, hyperactivity, inattention, and behavior problems that characterize children diagnosed with pediatric bipolar disorder. These mood and behavior symptoms are usually present since the early preschool years, unlike true bipolar disorder, which has onset in adolescence or, more commonly, in young adulthood. Dr. Kaplan reviews scientific studies that show true bipolar disorder is not present in children under 12 years of age. Further, he cites studies claiming that “pediatric bipolar disorder” is more common than prevalence rates for bipolar disorder in adults. This would mean that many children with pediatric bipolar disorder do not grow up to become adults with bipolar disorder, which does not make sense.

In over 30 years of clinical practice, I have seen many children considered to have pediatric bipolar disorder and have yet to meet one whose symptoms are not better explained by combined ADHD and ODD, consistent with Dr. Kaplan’s contention. Several studies have shown that ODD rarely exists without ADHD. Data I recently analyzed on over 500 children who met DSM-IV diagnostic criteria for ODD showed that all were also irritable, angry, explosive, and/or moody. Therefore, these symptoms are part of ODD and are not a separate or different disorder. As noted by Dr. Kaplan, misdiagnosing children with ADHD and ODD as having bipolar disorder results in these children not receiving the appropriate and scientifically proven intervention they need.

Dr. Kaplan has reviewed a plethora of scientific studies, media articles, and books on pediatric bipolar disorder. He eloquently interweaves clinical case examples with research evidence producing a convincing argument against pediatric bipolar disorder. After reading this book, families and professionals will have no trouble differentiating true bipolar disorder from combined ADHD and ODD and will know what evidence-based interventions are available to treat ADHD and ODD.  Dr. Kaplan’s book is an essential guide for clinicians and parents for understanding, diagnosing, and treating what is often mistakenly referred to as pediatric bipolar disorder.
—Susan D. Mayes, Ph.D., Chief Clinical Psychologist and Professor of Psychiatry, Penn State College of Medicine

Your Child Does Not Have Bipolar Disorder presents in clear prose a very well-informed, solidly argued expose of a current, highly problematic, and misleading psychiatric diagnosis in children.  The author is a seasoned clinician, researcher and academic who is passionate about improving diagnostic accuracy in the field.  
—Daniel Safer, M.D., Associate Professor, Depts. of Psychiatry and Pediatrics, Johns Hopkins University School of Medicine   

With his carefully crafted examination of the lack of a substantial basis for the existence of Bipolar Disorder in prepubescent children, Kaplan throws down the gauntlet to the media, the pharmaceutical companies hawking drugs to "stabilize moods" and the researchers who have "invented" this condition.  Parents reading this book should be assured that their preadolescent child does not have bipolar disorder, and Kaplan not only describes some of the sources of the worrisome behaviors of aggression, anger, hyperactivity, mood swings, and difficulties negotiating the social and educational demands of childhood, but also strongly endorses effective treatments, including medication, behavioral interventions, and family support.  
—Lee Combrinck-Graham, M.D., Associate Clinical Professor, Yale Child Study Center

At last there is a book that clinicians can refer to parents for an alternative view of the “bipolar child.” Dr. Kaplan has tackled a highly controversial topic area and with his significant experience and familiarity with the relevant research literature has crafted a work that provides parents a guide to better understand the symptoms, classification, and treatment of the child with severe mood dysregulation and problematic, highly labile behavior. The author has not disguised his own views but does provide both sides of the bipolar disorder diagnosis and its treatment in grade-school children. This is done in an easily led, almost chatty manner for parents and those caring for this very difficult pediatric population. The book should be of value to primary care physicians and related health sector and school personnel and parents of these children.
—Theodore A. Petti, M.D., M.P.H., Professor of Psychiatry and Director of Child and Adolescent Psychiatry, Robert Wood Johnson Medical School — University of Medicine and Dentistry of New Jersey

Read the review by Dr. Peggy Scallon, Clinical Assistant Professor and Residency Training Director in Child and Adolescent Psychiatry at the University of Wisconsin School of Medicine and Public Health. 

Read the review by Dr. Peter Parry, Child & Adolescent Psychiatrist Division of Nundah Child and Youth Mental Health Service. Subscribers to Australasian Psychiatry can also access the review via Sage Journals.