‘Paediatric bipolar disorder’ rates are lower than claimed – a reexamination of the epidemiological surveys used by a meta‐analysis

2017 ◽  
Vol 23 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Peter Parry ◽  
Stephen Allison ◽  
Tarun Bastiampillai
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Epidemiological Surveys ◽  
Paediatric Bipolar Disorder

scholarly journals ‘Pediatric Bipolar Disorder’ Rates are Still Lower than Claimed – A Re-examination of Eight Epidemiological Surveys used by an Updated Meta-analysis

2020 ◽  
Author(s):  
Peter Parry ◽  
Stephen Allison ◽  
Tarun Bastiampillai
Keyword(s):  
Bipolar Disorder ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Pediatric Bipolar Disorder ◽  
Bipolar Spectrum ◽  
Community Surveys ◽  
Bipolar Spectrum Disorder ◽  
Epidemiological Surveys ◽  
Highly Cited

Abstract Background: ‘Pediatric bipolar disorder’ (PBD) is a controversial diagnosis with varying rates of clinical diagnosis. A highly cited meta-analysis (Van Meter et al. 2011) of a dozen epidemiological surveys suggested a global community prevalence of 1.8%. This was further updated to 3.9% with eight additional surveys (Van Meter et al. 2019a). A narrative analysis (Parry et al. 2018) of the original 12 surveys concluded rates of PBD were substantially lower than 1.8% and led to a nine-article debate on the validity, overdiagnosis and iatrogenic aspects of the PBD diagnosis (e.g. Carlson and Dubicka 2019). This article extends the narrative analysis to include the eight newer community surveys.Methods: In terms of the Cochrane Handbook for Systematic Reviews of Interventions, the heterogenous community surveys were arguably unsuitable for statistical meta-analysis and warranted a narrative analysis.Results: Across all twenty surveys there was significant variation in methodologies and reported prevalence rates. Of the eight newer surveys, five (two Brazilian, one English, one Turkish, one United States) provided information of pre-adolescent rates of bipolar spectrum disorder. These pre-adolescent rates were zero or close to zero. Rates of adolescent hypomania/mania were higher, but follow-up data suggested most hypomania did not progress to adult bipolar disorder.Limitations: Methods in the original surveys vary and criteria used for various bipolar diagnoses were not always fully described. This limitation applies to a narrative analysis but also to a statistical meta-analysis.Conclusion: Bipolar disorder is very rare in childhood and rare in adolescence. PBD as a diagnostic construct fails to correlate with adult bipolar disorder and the term should be abandoned. Hypomanic syndromes in adolescence may not progress to adult bipolar disorder. Early diagnosis of bipolar disorder is important, but over-diagnosis risks adverse iatrogenic consequences.

scholarly journals ‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Peter Parry ◽  
Stephen Allison ◽  
Tarun Bastiampillai
Keyword(s):  
Bipolar Disorder ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Pediatric Bipolar Disorder ◽  
Prevalence Rates ◽  
Community Surveys ◽  
Bipolar Spectrum Disorder ◽  
Epidemiological Surveys ◽  
Highly Cited

Abstract Background ‘Pediatric bipolar disorder’ (PBD) is a controversial diagnosis with varying rates of clinical diagnosis. A highly cited meta-analysis (Van Meter et al. 2011) of a dozen epidemiological surveys suggested a global community prevalence of PBD of 1.8%. This was updated to 3.9% with eight additional surveys (Van Meter et al. 2019a). In terms of the Cochrane Handbook for Systematic Reviews of Interventions, the heterogenous community surveys were arguably unsuitable for statistical meta-analysis and warranted a narrative analysis. A narrative analysis (Parry et al. 2018) of the original 12 surveys concluded rates of PBD were substantially lower than 1.8% and led to a nine-article debate on the validity, arguable overdiagnosis and iatrogenic aspects of the PBD diagnosis (e.g. Carlson and Dubicka Child Adolesc Mental Health 21:86–87, 2019). This article extends the narrative analysis to include the eight newer community surveys. Methods A narrative analysis of the methodologies and the prevalence rates reported by the epidemiological surveys. Results Across all twenty surveys there was significant variation in methodologies and reported prevalence rates. Of the eight newer surveys, five (two Brazilian, one English, one Turkish, one United States) provided information of pre-adolescent prevalence rates of bipolar spectrum disorder. These pre-adolescent rates were zero or close to zero. Rates of adolescent hypomania and mania were higher, but follow-up data in two studies suggested hypomania might sometimes achieve prolonged remission or not lead to adult bipolar disorder. Limitations Methods in the original surveys vary and criteria used for various bipolar diagnoses were not always fully described. This limitation applies to a narrative analysis but also to a statistical meta-analysis. Conclusion Bipolar disorder is very rare in childhood and rare in adolescence. PBD as a diagnostic construct fails to correlate with adult bipolar disorder and the term should be abandoned. Hypomanic syndromes in adolescence may not always progress to adult bipolar disorder. Early diagnosis of bipolar disorder is important, but over-diagnosis risks adverse iatrogenic consequences.

P.331 Meta-analysis on tryptophan catabolites in bipolar disorder

2021 ◽  
Vol 44 ◽  
pp. S61-S62
Author(s):  
K. Hebbrecht ◽  
K. Skorobogatov ◽  
E. Giltay ◽  
M. Morrens
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Tryptophan Catabolites

Emotion regulation in pediatric bipolar disorder: A meta-analysis of published studies

2021 ◽  
Vol 285 ◽  
pp. 86-96
Author(s):  
Tatiana Cohab Khafif ◽  
Luisa de Siqueira Rotenberg ◽  
Camila Nascimento ◽  
Gabriel Henrique Beraldi ◽  
Beny Lafer
Keyword(s):  
Bipolar Disorder ◽  
Emotion Regulation ◽  
Meta Analysis ◽  
Pediatric Bipolar Disorder

Clozapine in bipolar disorder: A systematic review and meta-analysis

2020 ◽  
Vol 125 ◽  
pp. 21-27 ◽  
Author(s):  
Andre Delgado ◽  
Jorge Velosa ◽  
Junyu Zhang ◽  
Serdar M. Dursun ◽  
Flavio Kapczinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Meta Analysis
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