February 09, 2009Unlike US, Australia Is Skeptical Of The Bipolar Child ParadigmMost of you are well aware of the controversy around child bipolar disorder and of how some of its key proponents have become enmeshed in controversy. I won't restate any of that here. What I will note, however, is that in Australia several child psychiatrists have gotten vocal on the issue, perhaps in an attempt to preempt the controversial diagnosis' invasion of their nation. Anyway, there was a good article on all of this in the Sydney Morning Herald today (actually Jan. 10 over there) and Peter Parry, who's a reader of this site, was quoted. "The British National Institute for Health and Clinical Excellence rejects as theory the suggestion that children suffer bipolar disorder. It warns it could lead to overmedication. Isn't it interesting that in Britain NICE considers the bipolar child stuff to be "theory" while in the US the nice folks at Harvard consider it rock solid science? Isn't it telling that all these kids are getting diagnosed in the US when Down Under docs say they've never seen a case or very few? Australia isn't different enough from the US for anyone to argue huge differences in genetics as being the difference. It seems to me that their medical culture is a lot more conservative when it comes to addressing child behavior. Just so we are all clear, the article is discussing bipolar disorder in children, not teens. It's fairly clear to me that bipolar disorder can pop up in teens--hence the pediatric bipolar disorder label being bandied about, although who knows what the appropriate prevalence would be--but when it comes to kids younger than, say, 12 years old, I am very, very skeptical of its presence. I know there are some skeptics within child psychiatry in the US, but their voices have been effectively crowded out. Posted by Philip Dawdy at February 9, 2009 12:03 AM
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On the other hand, Australia brought the world lithium therapy for bipolar disorder, for better or worse. Make of that what you will. Posted by: Larry at February 9, 2009 07:43 AMI'm a bit confused. Wasn't is Australia which, you reported, was using ECT to treat bipolar in children under 4? Posted by: bromac at February 9, 2009 09:05 AMIt is time to squelch this malicious rumor about young children receiving ECT in Australia. Being from Down Under myself, I contacted a former colleague, who committed to investigate the matter. Here is his follow-up:
The DHS in Victoria has found that all their cases were data entry faults. As expected, no-one under 16 had ECT. The Commonwealth Health Insurance Commission (HIC) gets returns on all Medicare benefit items, of which ECT is one. Hence they note all ECTs given in private. They have found that every case of child ECT was mistaken. All were due to faulty data entry or occurred when a child had the same name as a parent receiving ECT and was thus listed on the same Medicare Card which is similar to a credit card and is used in all health case transactions in private. I am sorry if I am stating the obvious about Medicare, but it may help clarify those issues with your colleagues. I am unsure if there is a mole in the HIC or if the information were gained from an FOI query by someone with a probable negative interest. There is little investigative reporting in Australia so it is likely that the reporter was fed the material.
Bernard Carroll. Philip Dawdy responds: so you and others know, i've heard from two different sources that the data was flawed. i'm trying to confirm this for myself and will amend my earlier piece appropriately when i get confirmation. but yes it appears that the reporter either did sloppy work or got duped by flawed data. Bipolar Ability bipolar disorder certainly does exist in children. i have absolute no doubt of that, i know too many children who have it. i do, however, think it is overdiagnosed, and overmedicated, and that the drugs we are giving are children are not safe - for the simple fact that we cannot trust pharma nor our doctors. Posted by: anon mom at February 9, 2009 12:44 PMPost a comment
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