Experts on both sides agree that the 1999 publication of "The Bipolar Child" had a galvanizing effect. Supporters of early diagnosis and treatment say the book empowered parents and informed clinicians. Critics say it is rife with pseudoscience and exaggeration.
Written by New York psychiatrist Demitri Papolos, research director of the Juvenile Bipolar Research Foundation, and his wife, Janice, the book has sold more than 100,000 copies and led to the couple's appearances on "Oprah" and NPR's "Morning Edition." It is the book DeWeese said she relied on and the one the Virginia Beach psychiatrist used in diagnosing her children.
Experts are questioning the rise in pediatric diagnosis of bipolar illness.
(Randy Mays For The Washington Post)
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Kids and Bipolar Disorder: Dr. Jon McClellan discussed the growing number of pre-adolescent children diagnosed with bipolar disorder.
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"This book revolutionized child psychiatry," said Washington University in St. Louis psychiatry professor Barbara Geller, who called it "data-free" and "very controversial."
Geller said she thinks the book had a positive influence because parents read it "and began pouring into child psychiatry clinics" for help.
"When I give talks now, it's a very different response than five or 10 years ago," said Geller, who is conducting a long-term study of bipolar children funded by NIMH. "The reaction used to be, 'I don't really believe it's out there.' " Now, she said, the question she hears is, "How can I recognize it?"
The 419-page second edition is replete with anecdotes, many of them desperate parents' postings from Web sites. It lists famous people the authors say were bipolar, including Abraham Lincoln, Ludwig van Beethoven and Teddy Roosevelt. And it describes what the authors call "ultra ultra rapid cycling" -- mood swings that occur as often as every few minutes throughout the day, a phenomenon some child psychiatrists say they have never observed.
Among the book's most controversial features is its list of more than three dozen symptoms commonly seen in bipolar children, including silliness, separation anxiety, night terrors, carbohydrate cravings, fidgetiness, extreme bossiness, bed-wetting, lying, social anxiety and difficulty getting up in the morning.
"That book cast such a wide net that everyone is being called bipolar," said Parmajt Joshi, chief of psychiatry at Children's National Medical Center in Washington. "There are too many kids whose parents read the book and come in and say, 'I think my kid has this,' when they don't. "We see that a lot."
Houston child psychiatrist Laurel L. Williams says she has "un-diagnosed" between 50 and 75 children in the past few years who had been declared bipolar by other physicians, mostly psychiatrists. Last April she published a study in Psychiatric Times detailing the cases of three preschoolers whose symptoms resulted from communication disorders, not manic depression.
Papolos said he doesn't believe his book has contributed to misdiagnosis.
"If they read our book, I think they see a symptom picture in their children that is fairly comprehensive," he said.
