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A new study finds that the number of American children and teens treated for bipolar disorder increased forty times over between 1993 and 2003.
Researchers from New York, Maryland and Madrid surveyed records of office visits to doctors in private or group practices kept by the National Center for Health Statistics. They found that the number of diagnoses of bipolar disorder in children increased from 20,000 in 1994 to 800,000 in 2003. About two-thirds of those diagnosed were boys. Half had comorbidities such as attention deficit disorder. This means that about one in every 100 Americans under age 20 years has the diagnosis. 
The increase in diagnoses is controversial among child psychiatrists. Many believe that bipolar disorder, formerly called manic-depression, does not appear until adulthood. Many children diagnosed with bipolar disorder do not grow into adults with classic symptoms of mania and depression. Adults with the disorder suffer from extreme mood swings, ranging from high-energy cycles of mania to episodes of depression. More women than men have mood disorders.
Others believe that pediatric bipolar disorder has probably always been prevalent in children, but it is only now being diagnosed. Children with the disorder typically take drugs similar to those prescribed to adult patients. Many parents report that drugs and therapy have stabilized their formerly unmanageable children.
"The increase (in diagnoses) shows that the field is maturing, but the tremendous controversy reflects the fact that we haven't matured enough," said Dr. John March, chief of adolescent psychiatry at the Duke University School of Medicine. "From a developmental point of view, we simply don't know how accurately we can diagnose bipolar disorder."
This study appears in the September issues of the Archives of General Psychiatry.