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

  • Joe Clacey (a1), Michael Goldacre (a2) and Anthony James (a3)
Abstract
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.

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Copyright
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/).
Corresponding author
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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Declaration of interest

None.

Footnotes
References
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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.
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.
3 Van Meter, AR, Moreira, AL, Youngstrom, EA. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry 2011; 72: 1250–6.
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.
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.
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.
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.
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.
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.
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.
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.
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.
13 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. WHO, 1993.
14 World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD–9). WHO, 1978.
15 World Health Organization. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). WHO, 2009.
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.
17 Berry, G, Armitage, P. Mid-P confidence intervals: a brief review. Stat 1995; 44: 417–23.
18 Crow, E, Gardener, RS. Confidence interval for the expectation of a Poisson variable. Biometrika 1959; 46: 441–53.
19 Wennberg, J. Forty years of unwarranted variation–and still counting. Health Policy 114: 12.
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/.
21 American Psychiatric Association. Diagnostic and Statistical Manual of mental Disorders, 5th edn 5th edn (DSM-5). APA, 2013.
22 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). 1994.
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.
24 Wozniak, J, Biederman, J. Childhood mania: insights into diagnostic and treatment issues. J Assoc Acad Minor Phys 1997; 8: 7884.
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.
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.
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.
28 Mackin, P, Targum, SD, Kalali, A, Rom, D, Young, AH. Culture and assessment of manic symptoms. Br J Psychiatry 2006; 189: 379–80.
29 Parry, PI, Levin, EC. Pediatric bipolar disorder in an era of “mindless psychiatry”. J Trauma Dissociation 2012; 13: 5168.
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Paediatric bipolar disorder: international comparisons of hospital discharge rates 2000–2010

  • Joe Clacey (a1), Michael Goldacre (a2) and Anthony James (a3)
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