OBJECTIVE: There is considerable skepticism outside the US over the prevalence of pediatric bipolar disorder (BD). We wished to evaluate the epidemiology of BD in children and adolescents in non-US samples. METHOD: We reviewed studies on the prevalence of BD in children and adolescents in international samples. We also describe our sample of 27 children with BD at the University of Navarra. RESULTS: There are important and frequently overlooked differences in the definition of BD between the International Classification of Diseases 10th edition (ICD-10) and DSM-IV and methodological differences in epidemiological studies that may partially explain international differences in prevalence of pediatric BD. The prevalence of bipolar spectrum disorder in young adults in Switzerland is 11%. In Holland the 6-month prevalence of mania in adolescents was 1.9% and of hypomania 0.9%. Only 1.2% of hospitalized youth (<15 years) in Denmark and 1.7% of adolescents in Finland had BD. In our clinic, the prevalence of DSM-IV BD in children 5-18 years old is 4%, and of any mood disorders 27%. There are also data from Brazil, India and Turkey with varying results. CONCLUSION: Relative lack of data, ICD-10 and DSM-IV differences in diagnostic criteria, different levels of recognition of Child and Adolescent Psychiatry as a true specialty in Europe, clinician bias against BD, an overdiagnosis of the disorder in USA and/or a true higher prevalence of pediatric BD in USA may explain these results. US-International differences may be a methodological artifact and research is needed in this field.
OBJECTIVE: There is considerable skepticism outside the US over the prevalence of pediatric bipolar disorder (BD). We wished to evaluate the epidemiology of BD in children and adolescents in non-US samples. METHOD: We reviewed studies on the prevalence of BD in children and adolescents in international samples. We also describe our sample of 27 children with BD at the University of Navarra. RESULTS: There are important and frequently overlooked differences in the definition of BD between the International Classification of Diseases 10th edition (ICD-10) and DSM-IV and methodological differences in epidemiological studies that may partially explain international differences in prevalence of pediatric BD. The prevalence of bipolar spectrum disorder in young adults in Switzerland is 11%. In Holland the 6-month prevalence of mania in adolescents was 1.9% and of hypomania 0.9%. Only 1.2% of hospitalized youth (<15 years) in Denmark and 1.7% of adolescents in Finland had BD. In our clinic, the prevalence of DSM-IV BD in children 5-18 years old is 4%, and of any mood disorders 27%. There are also data from Brazil, India and Turkey with varying results. CONCLUSION: Relative lack of data, ICD-10 and DSM-IV differences in diagnostic criteria, different levels of recognition of Child and Adolescent Psychiatry as a true specialty in Europe, clinician bias against BD, an overdiagnosis of the disorder in USA and/or a true higher prevalence of pediatric BD in USA may explain these results. US-International differences may be a methodological artifact and research is needed in this field.
Authors: Michael Bauer; Tasha Glenn; Martin Alda; Ole A Andreassen; Raffaella Ardau; Frank Bellivier; Michael Berk; Thomas D Bjella; Letizia Bossini; Maria Del Zompo; Seetal Dodd; Andrea Fagiolini; Mark A Frye; Ana Gonzalez-Pinto; Chantal Henry; Flávio Kapczinski; Sebastian Kliwicki; Barbara König; Mauricio Kunz; Beny Lafer; Carlos Lopez-Jaramillo; Mirko Manchia; Wendy Marsh; Mónica Martinez-Cengotitabengoa; Ingrid Melle; Gunnar Morken; Rodrigo Munoz; Fabiano G Nery; Claire O'Donovan; Andrea Pfennig; Danilo Quiroz; Natalie Rasgon; Andreas Reif; Janusz Rybakowski; Kemal Sagduyu; Christian Simhandl; Carla Torrent; Eduard Vieta; Mark Zetin; Peter C Whybrow Journal: Bipolar Disord Date: 2012-05-21 Impact factor: 6.744