Symptoms and Diagnosis of Pediatric Bipolar Disorder Essay Example
Controversy exists regarding the diagnosis of pediatric bipolar disorder, including debates about symptom accuracy and criteria for duration and severity. As a result, many children with psychological disorders go undiagnosed for extended periods.
There is controversy surrounding the diagnosis and treatment of pediatric bipolar disorder. Many children with comorbid ADHD receive medications like antidepressants or stimulants, but they often do not receive the necessary atypical antipsychotic or mood stabilizer treatments. Unlike adults, children with bipolar disorder do not typically have discrete episodes, which adds to the debate. Instead, young pediatric patients often experience intense mood swings that cause significant educational or social problems. These mood swings occur rapidly and transiently, sometimes happening multiple times within 24 hours (known as "ultradian" cycling). The controversy is also fueled by the fact that extreme manifestations of impulsivity, a
...ctivation, anger, and irritability observed in these children can also be seen in other pediatric disorders such as oppositional defiant disorder, ADHD, or major depressive disorder. This paper examines two articles that contribute to this ongoing debate.
This paper examines two articles: "Childhood-onset Bipolar Disorder: The Perfect Storm" by Robert Post and "Pediatric Bipolar Disorder: Underdiagnosed or Fiction?" by Daniel Sahling. In his article, Post identifies five key factors hindering the appropriate diagnosis and treatment of adolescents with childhood-onset bipolar disorder. He emphasizes the seriousness of this illness and its negative long-term effects on individuals and their families. These factors collectively create what Post refers to as the "perfect storm." According to him, the first factor is that the diagnosis is common, the impairment is severe, and treatment is difficult. Post argues that researchers agree on the existence of pediatric bipolar disorde
and believe that early treatment at this stage offers the best opportunity for studying the disorder and improving patient prognosis (Post, 2009).
Post (2009) argues that the second storm in the diagnostic controversy is the difficulty in distinguishing between anxiety, mood, and personality disorders due to their shared characteristics. This overlap poses challenges in accurately diagnosing these conditions, leading to errors in diagnosis, increased symptom severity, and poorer patient prognosis. Additionally, there is a lack of data directly linking the controversial bipolar subtypes or imitators to effective treatment. Consequently, pediatric patients with these conditions are often treated with stimulants and antidepressants meant for uncomplicated ADHD, resulting in a delay in proper treatment. Lastly, the increase in the diagnosis of pediatric bipolar has caused a neglectful attitude among practitioners, who fail to recognize the need for dramatic psychiatric intervention for these patients.
In this text, it is pointed out that practitioners neglect the importance of providing relevant psychiatric care to pediatric patients. This delay in medical care affects this group of patients. The difficulties in accessing evaluation and treatment also contribute to the problem, as patients do not have appropriate coverage or support systems to help them get diagnosed and treated early enough. The text suggests several solutions to address this issue, including conducting thorough investigations into different variants of pediatric bipolar disorder, carrying out clinical trials for treatment options, and developing a treatment outcome network to provide practitioners with initial data on effective treatment practices (Post, 2009). The article by Daniel Sahling explores the rise in diagnoses of pediatric bipolar disorder and examines various factors mentioned by Post. Specifically, Sahling investigates the underdiagnosis or lack of
recognition of pediatric bipolar disorder by practitioners, the attribution of symptoms to medication side effects and iatrogenic effects, and changes in the diagnostic system to include normal childhood behaviors that were previously considered symptoms of pediatric bipolar disorder.
Sahling (2009) concludes that the increase in pediatric bipolar disorder is due to the alteration to the diagnostic model and iatrogenic effects of psychostimulant medications. Both authors' articles provide strong arguments supported by evidence ranging from level one to four on the evidence hierarchy, which adds credibility and robustness to their claims. Moreover, a closer analysis of the two articles reveals that the authors are guided by a common assumption: the existence of a cohort of children in child psychiatry clinics exhibiting severe affective aggression, irritability, or rage, with impairing explosive behavior that researchers have attempted to explain with various diagnoses over the years, yet with minimal success in treatment.
The authors of the article agree that pediatric disorder is a complex disorder with various causes. They believe that more research is needed to distinguish this disorder from other similar disorders and improve the delayed treatment and poor prognosis experienced by these patients. Both authors also recommend similar actions to practitioners in this field. Post urges organizations like NIMH to take more action in treatment research, while Sahling calls for ethical practitioners to advise parents about the potential factors in psychostimulant drugs. However, upon evaluation, I find that Post's article presents a compelling argument. He thoroughly examines each factor contributing to the under-diagnosis of pediatric bipolar disorder and provides extensive empirical evidence to support his claims. Unlike Sahling, he establishes a connection between the five storms and illustrates how
each storm leads to the next and ultimately creates a "perfect storm." Additionally, Post offers practical solutions at both legislative and practice levels to address this issue.The ongoing controversy arguments put forth by Post are echoed by current researchers, including Daniel Dickstein and Ellen Leibenluft (2012).
The ongoing controversy surrounding pediatric bipolar disorder leads to delayed treatment for these patients, as discussed by Post and Sahling. They analyze the causes of this controversy and its impact on treatment delays. The authors suggest potential solutions for practitioners in abnormal psychology to address the controversy and improve patient prognosis within this specific population.
References
- Dickstein, D. P., & Leibenluft, E. (2012). Beyond Dogma: From Diagnostic Controversies to Data about Pediatric Bipolar Disorder and Children with Chronic Irritability and Mood Dysregulation. The Israel Journal of Psychiatry and Related Sciences, 49(1), 52–61.
- Post, R. (2009). Childhood-Onset Bipolar Disorder: The Perfect Storm. Psychiatric Annals, 39(10), 879-886. http://dx.doi.org/10.3928/00485718-20090924-06.
- Sahling, D.
This text provides details about an article titled "Pediatric Bipolar Disorder: Underdiagnosed or Fiction?" which was published in the Ethical Human Psychology and Psychiatry journal in 2009. The article is featured in volume 11, issue 3, spanning pages 215-228. To access the article, please visit this URL: http://dx.doi.org/10.1891/1559-4343.11.3.215
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