Abstract
Objective
To test the hypothesis that US clinicians diagnose prepubertal mania more commonly than UK clinicians.
Methods
Five vignettes were presented to 73 UK clinicians and 85 US clinicians. Four cases represented complex scenarios where the diagnosis of mania was thought to be controversial, and one case was a ‘classical’ case of mania in an older child where it was thought there would be good agreement. Clinicians were asked to determine symptoms of mania, and their preferred diagnoses.
Results
As predicted, overall there were significantly more diagnoses of mania in the US than the UK (P ≤ 0.0001). US clinicians were significantly more likely to diagnose mania in three of the four complex cases, and there was good agreement in the case of classical mania. In addition, UK clinicians were significantly more likely to diagnose pervasive developmental disorders and adjustment disorders, whereas obsessive compulsive disorder was more commonly diagnosed in the US.
Conclusion
There may be differences in how clinicians in the US and UK interpret mania-like symptoms in younger children, which may have implications for diagnosis and management.
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References
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington, DC
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
Biederman J, Faraone S, Chu MP, Wozniak J (1999) Further evidence of a bidirectional overlap between juvenile mania and conduct disorder in children. J Am Acad Child Adolesc Psychiatry 38:468–476
Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson B (1996) Childhood and adolescent depression: a review of the past 10 years. Part I. J Am Acad Child Adolesc Psychiatry 35:1427–1439
Blader JC, Carlson GA (2007) Increased rates of bipolar disorder diagnoses among U.S. child, adolescent, and adult inpatients, 1996–2004. Biol Psychiatry, 2007 Feb 15 (Epub ahead of print)
Carlson GA (1998) Mania and ADHD: comorbidity or confusion. J Affec Disord 51:177–187
Carlson GA (2005) Early onset bipolar disorder: clinical and research considerations. J Clin Child Adolesc Psychol 34:333–343
Cooper JE, Kendall RE, Gurland BJ, Sharpe L, Copeland JRM, Simon R (1972) Psychiatric diagnosis in New York and London: a comparative study of mental hospital admissions. Institute of Psychiatry, Maudsley Monographs (20)
Costello EJ, Angold A, Burns BJ, Stangl DK, Tweed DL, Erkanli A, Worthman CM (1996) The Great Smoky Mountains Study of Youth. Goals, design, methods and the prevalence of DSM-III-R disorders. Arch Gen Psychiatry 53:1129–1136
Costello EJ, Mustillo S, Erkanli A, Keeler GMS, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844
Harrington R, Myatt T (2003) Is preadolescent mania the same condition as adult mania? A British perspective. Biol Psychiatry 53:961–969
Judd LL, Akiskal HS (2003) The prevalence and disability of bipolar spectrum disorders in the US population: the ECA database taking into account subthreshold cases. J Affec Disord 73:123–131
Kent L, Craddock N (2003) Is there a relationship between attention deficit hyperactivity disorder and bipolar disorder? J Affect Disord 73:211–221
Lewinsohn PM, Klein DN, Seeley JR (1995) Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. J Am Acad Child Adolesc Psychiatry 34:454–463
Meltzer H, Gatward R, Goodman R, Ford T (2000) The mental health of children and adolescents in Great Britain. The Stationary Office, London
Milberger S, Biederman J, Faraone SV, Murphy J, Tsuang MT (1995) Attention deficit hyperactivity disorder and comorbid disorders: issues of overlapping symptoms. Am J Psychiatry 152:1793–1799
National Collaborating Centre for Mental Health (2006) Bipolar disorder: the management of bipolar disorder in adults, children and adolescents in primary and secondary care. Clinical guideline 38. National Institute of Clinical Excellence, London (http://www.nice.org.uk/CG038)
Pavuluri MN, Birmaher B, Naylor MW (2005) Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 44:846–871
Prendergast M, Taylor E, Rapoport JL, Bartko J, Donnelly M, Zametkin A, Ahearn MB, Dunn G, Wieselberg HM (1988) The diagnosis of childhood hyperactivity. A US–UK cross-national study of DSM-III and ICD-9. J Child Psychol Psychiatry 29:289–300
Taylor E, Sandberg S (1984) Hyperactive behaviour in English schoolchildren: a questionnaire survey. J Abnorm Child Psychol 12:143–155
Youngstrom EA, Duax J, Hamilton J (2005) Evidence-based assessment of pediatric bipolar disorder, Part I: base rate and family history. J Am Acad Child Adolesc Psychiatry 44:712–717
World Health Organisation (1973) Report of the International Pilot Study of Schizophrenia. WHO, Geneva
World Health Organisation (1978) International classification of diseases, 9th edn. WHO, Geneva
World Health Organisation (1992) ICD-10: the ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. WHO, Geneva
Acknowledgments
This work was supported by a grant from the Central Manchester and Manchester Children’s University Hospitals National Health Service Trust, UK.
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Richard Harrington—Deceased
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Dubicka, B., Carlson, G.A., Vail, A. et al. Prepubertal mania: diagnostic differences between US and UK clinicians. Eur Child Adolesc Psychiatry 17, 153–161 (2008). https://doi.org/10.1007/s00787-007-0649-5
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DOI: https://doi.org/10.1007/s00787-007-0649-5