NOTE( my position is against the issue of diagnosing pediatric bipolar depression disorder)<\/p>\n
Please cite References<\/p>\n
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\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Main Post<\/p>\n
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Pediatric Bipolar Depression<\/strong><\/p>\n The \u00a0American Psychiatric Association (2013) requires one manic episode or \u00a0one hypomanic episode along with one depressive episode for a diagnosis \u00a0of Bipolar Disorder. There has been some controversy over using the \u00a0diagnosis of Pediatric Bipolar Disorder (PBD) due to what some believe \u00a0was over-diagnosis resulting in a higher prevalence of the disorder in \u00a0the United States, showing up to a 40-fold increase in the diagnosis in \u00a0the previous decade (Van Meter, Moreria & Younstrom, 2019).\u00a0\u00a0<\/p>\n Arguing FOR the Diagnosis<\/strong><\/p>\n While \u00a0there was some debate for a period of time regarding over-diagnosis of \u00a0PBD, Van Meter et al. (2019) suggest that rates of pediatric bipolar \u00a0disorder are not increasing and the rate is not higher in the United \u00a0States once meta-analysis is utilized to critically evaluate previous \u00a0data. Some previous criticism of PBD resulted in the APA (2013) \u00a0establishing the newer diagnosis of Disruptive Mood Disregulation \u00a0Disorder which addressed the primary issue of children presenting for \u00a0treatment with significant and pervasive irritability. An important \u00a0distinction that must be made is the difference between PBD and DMDD: \u00a0PBD has discrete episodes of irritability (mania) whereas in DMDD the \u00a0irritability is chronic and nonepisodic (Findling & Chang, 2018).\u00a0<\/p>\n With \u00a0no other diagnosis available in the past, it is possible that some of \u00a0these kids ended up with a PBD diagnosis for what was likely DMDD; \u00a0still, this fact does not negate the necessity for a PBD diagnosis to be \u00a0available. In fact, between 50-66% of adults with well-documented \u00a0bipolar disorder report having had symptoms prior to age 19 (Findling \u00a0& Chang, 2018). As has been well-established, earlier treatment and \u00a0intervention result in better outcomes (McGorry & Mei, 2018).<\/p>\n The \u00a0International Society for Bipolar Disorders Task Force (Goldstein et \u00a0al., 2017) found that the previous studies which resulted in much of the \u00a0debate appeared to be more influenced by training, conceptualization, \u00a0and insurance as opposed to true differences in prevalence. While the \u00a0Task Force acknowledges the need for more studies to more accurately \u00a0assess for hypomania and differentiation of PBD from non-mood \u00a0psychopathology, a need to recognize and diagnose PBD still remains. \u00a0McGorry and Mei (2018) make the case for earlier intervention for PBD \u00a0due to the fact that (1) earlier treatment is more effective, and (2) \u00a0recurrence is often associated with structural\u00a0 changes in the brain. \u00a0Considering this fact, and the new understanding that previous \u00a0\u201cover-diagnosis\u201d was probably not actually over-diagnosis, recognizing \u00a0and treating PBD remains a critical piece of pediatric psychiatry.\u00a0<\/p>\n My Takeaway<\/strong><\/p>\n When \u00a0I began reading about pediatric bipolar disorder, I was initially \u00a0inclined to think that it would be difficult to differentiate PBD from \u00a0normal childhood mood swings. However, the more I read, the more clear \u00a0it became that by accurately diagnosing PBD, the better the outcomes. \u00a0Also, one thing that I noticed in several studies was the necessity for a \u00a0\u201cstructured interview\u201d in the diagnostic process. I have not seen that \u00a0done in real life, but it inspired me enough that I found a handbook and \u00a0manual, the Structured Clinical Interview for DSM-V<\/em>, from the American Psychiatric Association Publishing arm that I purchased for my own resources (https:\/\/www.appi.org\/Products\/Interviewing\/SET-of-SCID-5-CV-and-SCID-5-CV-Users-Guide<\/u><\/a>). \u00a0The bottom-line, for me, is to make sure that I remain open to what new \u00a0research shows and to remember that I will never know everything and \u00a0that I can always learn something new.<\/p>\n References<\/p>\n American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders<\/em><\/p>\n (5th ed.). Washington, DC: Author.<\/p>\n Findling, R.L. & Chang, K.D. (2018). Improving the Diagnosis and Treatment of Pediatric Bipolar<\/p>\n Disorder. Journal of Clinical Psychiatry, 79<\/em>(2), 62-69.\u00a0<\/p>\n Goldstein, B.I., Birmaher, B., Carlson, G.A., DelBello, M.P., Findling, R.L., Fristad, M.,\u00a0<\/p>\n Kowatch, R.A., Miklowitz, D.J., Nery, F.G., Perez-Algorta, G., Van Meter, A., Zeni, C.P.,<\/p>\n Correll, C.U., Kim, H.W., Wozniak, J., Chang, K.D., Hillegers, M. & Youngstrom, E.A.\u00a0<\/p>\n (2017). The International Society for Bipolar Disorders Task Force report on pediatric<\/p>\n bipolar disorder: Knowledge to date and directions for future research. Bipolar Disorders,<\/em><\/p>\n 19, <\/em>524-543. Doi: 10.111\/bdi.12556.<\/p>\n Van Meter, A., Moreira, A.L., & Youngstrom, E. (2019). Updated Meta-Analysis of\u00a0<\/p>\n Epidemiologic Studies of Pediatric Bipolar Disorder. Journal of Clinical Psychiatry, 80<\/em>(3),<\/p>\n e1-e11. doi: 10.4088\/JCP.18r12180.<\/p>\n \u00a0Reply Quote Email Author<\/a> \u00a0\u00a0<\/p>\n \n \u00a0Respond to \u00a0your \u00a0colleagues who argued the opposite side as you by countering their \u00a0argument with evidence. Identify at least two consequences to support \u00a0your position.\u00a0 [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[],"tags":[],"yoast_head":"\n\"Looking for a Similar Assignment? Order now and Get 10% Discount! Use Code \"Newclient\"<\/h5>\n
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