Diagnosing has bipolar disorder “the risk of the child

 

 

 

 

Diagnosing Bipolar Disorder in Pediatric
Populations: Fact or Fiction

Kyle R. Kendall

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University of Massachusetts, Amherst

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diagnosing bipolar disorder in pediatric
populations poses a special challenge as it is clinical accepted that the
presentation of bipolar is significantly differs from that of adults. However,
under the constraints of the DSM-V the criteria for diagnosing bipolar disease is
primarily based on research and studies conducted on adults thus leaving a
large margin of error when it comes to diagnosing a pediatric patient using this
criterion.  I believe that in fact
bipolar along with several other mental disorders begin to manifest during the
adolescence years, but they present themselves differently than that of a
classical presentation of an adult, largely in part due to the fact that the
adolescent is still developing and is heavily influenced by the living and social
environment they live in and spend most of their time in. According to Singh,
(2008) It is estimated that if one parent has bipolar disorder “the risk of the
child being diagnosed is 15-30% which increase to 50-75% if both parents have
bipolar”

I would say the largest issued in this topic is
that the DSM fails to provide a comprehensive evaluation to allow a clinician
to come to a definitive diagnosis whether that be pediatric bipolar disorder or
something along the lines of Pre-pubertal onset
manic depressive disorder. An example of what this might look like would be the
FIND assessment paired with both the YRMS and P-YMRS which would give you a three-sided
evaluation of the patient and provide a clinician with more information to make
a better destination as to the severity of the disorder. Singh, (2008) also
remarks that to a large extend the child’s environment plays a huge role,
meaning that a child may not have bipolar but due to a high stress environment
with several influencing factors may mimic symptoms of the disorder and
therefore be misdiagnosed. Using a tool such as the one aforementioned would
significantly reduce misdiagnosis as well as cut down on the number of pharmaceuticals
being prescribed to pediatric patients.

I come from a family with a history of depression, growing up I
was exposed to it almost constantly and my behavior began to show signs of
bipolar, (i.e drastic changes in mood) I began to mimic behavior that I was
seeing around me. My father acted as my advocate with my doctors as they looked
to the DSM as some sort of “cookie cutter overlay” and because I presented with
the criteria for pediatric bipolar disorder they wanted to start me on an aggressive
treatment of mood stabilizers as well as antidepressants.  Had my father not stepped in I can only begin
to imagine where and what my life would be like today. Studies have shown that
by simply removing the child from their everyday living environment for a small
amount of time (as little as 72 hours) that a child’s behavior who does not
actually meet criteria for a bipolar diagnosis will begin to normalize. (Martin,
2017)

In conclusion, I feel that bipolar disorder should be diagnosed
as early on as possible, with the notion to ensure all aspects of the child’s
daily life being taken into consideration as well as an extensive interview
with the child’s caregivers and parents prior to any clinical diagnosis or
treatment. Singh, (2008) reports that it can take on average up to 10 years to
properly diagnosis and treat a patient with bipolar, so why not try to get
ahead of the curve. Once a diagnosis is reached the treatment should rely as
little on pharmaceuticals as possible and the dosage and medication should be
reevaluated at each visit to the clinician.  There is a reason that doctors “practice”
medicine because there is no clear cut diagnosis and treatment plan for all
patients that present with a certain condition, the same cannot be more true in
the field of psychology. Given the proper time and tools to evaluate a pediatric
patient  I feel that a conclusive
clinical diagnosis of bipolar can be achieved amongst the pediatric aged
population. During the process all aspects of abnormal psychology need to be
evaluated to ensure that there

is not a single reason as for the child’s behavior and actions
other than that of a clinical diagnosis of bipolar.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

 

Parry, Peter I., and Edmund C. Levin. (2012)
“Pediatric Bipolar Disorder in an Era of “Mindless”
Psychiatry”.” Journal
of Trauma and Dissociation” 51-68. 

 

Singh, T. (2008). “Pediatric Bipolar Disorder: Diagnostic
Challenges in Identifying Symptoms and Course of Illness.” “Psychiatry” (Edgmont), 5(6), 34–42.

 

Stringaris, A., Baroni, A., Haimm, C., Brotman, M., Lowe, C.H., Myers, F. … and Leibenluft, E. ((2010). “Pediatric bipolar disorder versus severe mood dysregulation:
Risk for manic episodes on follow-up”. “Journal of the American Academy of Child and Adolescent
Psychiatry” 49: 397–405.

 

Martin, A., Bloch, M., and Volkmar. F. (2017)”Lewis’s
Child and Adolescent Psychiatry”(5th ed.). Lippincott Williams&
Wilkins (LWW)

 

 

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