FINDINGS

Tuesday, September 4, 2007

Bipolar Disorder Rise In Kids, Teens Doubted

A new analysis suggests a huge increase in the number of U.S. children and teenagers diagnosed with bipolar disorder, but experts question whether the surge is real and say some kids have been mislabeled.

Researchers looked at the number of times people younger than 19 went to the doctor and were diagnosed with or treated for bipolar disorder, also known as manic depression. They found a 40-fold increase over a decade, from an estimated 20,000 visits in 1994 to 800,000 in 2003. The jump coincided with the rising use of antipsychotic medicine for children.

The numbers echo other estimates suggesting that as many as 1 million U.S. children are bipolar, but it remains a controversial diagnosis in children. That is partly because their symptoms often differ from adults' and because most powerful antipsychotic drugs used to treat bipolar disorder were approved for adults and have not been well studied in children and adolescents.

Some doctors believe bipolar disorder does not occur in children, and until last month there was only one drug approved to treat the illness in kids.

The study's lead author, Mark Olfson of Columbia University and the New York State Psychiatric Institute, said the results likely reflect overdiagnosis now or underdiagnosis in the past, rather than a true increase. Olfson has received speaking fees from Janssen LP, which makes one of the pediatric bipolar drugs and has consulted for other makers of psychiatric drugs.

Symptoms include extreme mood swings and disruptive behavior. In children, extreme irritability is sometimes the main symptom.

The study appears in the September issue of Archives of General Psychiatry.

Obesity in Toddlers Tied to Low Iron Levels

Pudgy toddlers have an alarmingly high rate of iron deficiency, and Hispanic youngsters are more affected than other groups, a new study finds.

The study is the first to discover a link between obesity and low iron levels in toddlers. Iron deficiency can cause mental and behavioral delays, so the findings underscore the importance of healthful eating habits in children ages 1 to 3.

The researchers found that 20 percent of obese toddlers have iron deficiency, compared with 7 percent of normal-weight toddlers. Lack of iron reduces the amount of oxygen carried through the body by the blood and can cause anemia.

Experts blamed parents who let toddlers drink cow's milk and juice from a bottle, instead of weaning them from the bottle and introducing more iron-rich table foods, such as meat, beans, eggs, spinach and fortified breads.

Toddlers still fed from bottles tend to drink too much milk and juice, which are low in iron, and do not get enough solid food, said Jane Brotanek of the University of Texas Southwestern Medical Center in Dallas and a study co-author. The study appears in the September issue of the journal Pediatrics.

Children who attend day-care centers are about 50 percent less likely to have iron deficiency than children who are not in day care, the researchers found.

Hispanic toddlers were twice as likely than white and black toddlers to be obese and not in day care, possibly explaining their increased risk of iron deficiency, Brotanek said.

Study Counters Idea Of ADHD Overtreatment

Just a third of children meeting the diagnostic criteria for attention-deficit hyperactivity disorder are receiving medication, scientists said.

About 9 percent of children in the study, ages 8 to 15, met the criteria for ADHD. That is equivalent to about 2.4 million U.S. children, the researchers reported. Of these, only about a third received medication consistently in the previous year.

About 3 percent of those who did not meet the ADHD criteria were medicated for the disorder, said lead author Tanya Froehlich, a developmental-behavioral pediatrician and researcher at the Cincinnati Children's Hospital.

"There's a perception that ADHD is overdiagnosed and overtreated, so we wanted to see if that was true among those who met the disease criteria," Froehlich said. "We really wanted to take the best and most accurate look at how common ADHD is."

The study, published in the Archives of Pediatric & Adolescent Medicine, was not funded by a National Institutes of Health grant or by any companies that make ADHD drugs.

The researchers did not evaluate nonprescription treatments such as structured classroom management, parent education or behavioral therapy for the child, Froehlich said.

Poor children were more than twice as likely as their healthy peers to have the disorder, according to the study. Only 16 percent of the poorest children who had met the criteria for diagnosing the illness had received medication for the disease, and they were two-thirds less likely to receive medicine consistently.

-- From News Services