Academic journal article Journal of Child and Adolescent Psychopharmacology

Review of Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis, by Stuart L. Kaplan

Academic journal article Journal of Child and Adolescent Psychopharmacology

Review of Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis, by Stuart L. Kaplan

Article excerpt

[Author Affiliation]

Lauren Spring. Department of Psychiatry, Stony Brook University, Stony Brook, New York.

Kaplan, SL: Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis. ISBN: 978-0-313-38134-8. Santa Barbara, CA: Praeger, 2011. 184 pages.

Address correspondence to: Lauren Spring, MD, Fellow, Child & Adolescent Psychiatry, Department of Psychiatry, Putnam Hall-South Campus, Stony Brook University, Stony Brook, New York 11794-8790, E-mail: lauren.spring@sbumed.org

When a raging child is brought for the first appointment with a child and adolescent psychiatrist or other clinician with the question of "does my child have bipolar disorder," the response is often quite polarized. On the one hand, there is the view that "bipolar disorder" is common, and, therefore, that it is more than likely that an explosive child has it. The other view is considerable skepticism indicated by a suppressed "eye roll." The thesis set forth in Kaplan's Your Child Does Not Have Bipolar Disorder will resonate with clinicians who have observed this.

Kaplan "calls it as he sees it" in this review of one of the most controversial topics in child and adolescent psychiatry today: The diagnosis of bipolar disorder in children. Kaplan's opinion is that bipolar disorder is overly and wrongly diagnosed in children, leading children both to receive unhelpful treatments with potentially serious side effects and not to receive proven treatments to help their symptoms, namely stimulants. He refers to "pediatric bipolar disorder" as a "diagnosis with little evidence to support it" and "actually a severe form of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD)." The book is for parents of "very angry children with ADHD," but it is also an educational read for anyone in the field of psychiatry.

Kaplan is a clinical professor of psychiatry at Penn State College of Medicine in Hershey, Pennsylvania. He is board certified in adult as well as child and adolescent psychiatry. He has served as director of child and adolescent psychiatry at Long Island Jewish Medical Center-Zucker Hillside Hospital, St. Louis University, and Penn State College of Medicine. He has an outpatient practice and a blog on the topic of bipolar disorder in youth. Although he has published on topics that include depression in adolescence, emotion expression in children with ADHD, enuresis, pediatric psychopharmacology, and pharmacologic treatment of ADHD and depression in youth, he has not been a "player" in the bipolar disorder research arena.

Kaplan strategically builds his argument throughout the three sections of the book: Part I, Critique of Pediatric Bipolar Disorder; Part II, Medications and Pediatric Bipolar Disorder; and Part III, Advice for Parents. Like others writing on the bipolar controversy, he reviews and compares diagnostic criteria for mania, ADHD, and ODD, and then discusses areas of symptom overlap, for example, being talkative, increased motor activity, distractibility, and impulsivity. He includes a short description of what the Diagnostic Statistical Manual of Mental Disorders (DSM) is for parents who may not be familiar with psychiatric diagnoses and how they are made as well as common criticisms of the DSM. Despite DSM's shortcomings, Kaplan argues that it remains the current gold standard for diagnosis, and should be adhered to, so that diagnoses can be made consistently. In fact, he points out that the some of the leading researchers in this area, specifically Joseph Biederman of Harvard University and Barbara Geller of Washington University and their research groups have actually not adhered to Diagnostic Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for the diagnosis (American Psychiatric Association 1994).

Kaplan feels that the aforementioned researchers went astray by providing different definitions to be used for pediatric bipolar disorder. …

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