Posted by SLS on September 15, 2010, at 7:10:41
In reply to Re: hrguru - Re: Anti-psychotics not mood stabilizers?, posted by Simon Sobo, M.D. on September 15, 2010, at 5:52:23
> > > Bipolar disorder is being wildly overdiagnosed,
> >
> > We hear this quite often delivered as an opinion. What evidence can you cite that this is indeed true?
> >
> >
> > - Scott
> Allen Frances http://www.psychiatrictimes.com/dsm-5/content/article/10168/1425378?verify=0 in this link, head of the DSM IV taskforce, described a pseudoepidemic! of bipolar, autism, and ADHD as a result of DSM IV."For instance, a seemingly small change can sometimes result in a different definition of caseness that may have a dramatic and totally unexpected impact on the reported rates of a disorder.20 Thus are false epidemics created. For example, although many other factors were certainly involved, the sudden increase in the diagnosis of autistic, attention-deficit/hyperactivity, and bipolar disorders may in part reflect changes made in the DSM-IV definitions. Note this."
This is still opinion, and not the results of empirical study. Where is the evidence that there is indeed a "false epidemic" occurring? A sudden increase in the diagnosis of various disorders could be the result of greater accuracy in nosological categorization and diagnostics. Where are the numbers? You place so much importance on empirical evidence to substantiate your claims, but still produce no citations demonstrating such evidence.
> In my article, also in the Psychiatric Times, I describe the issue, confusion about what is meant by "mood swings".
Who or what is confused? Psychiatrists? DSM?
Mood dysregulation and mood lability are features of various mental disorders as is detailed in the DSM. Where is the confusion? Any misconception of the phenomenon of "mood swing" might be a part of pop-culture language rather than the result of scientific inquiry.
> I might also add that there was a 40 fold increase in the diagnosis of bipolar disorder in children over 10 years,
Where can I find out more about this number?
What would you say is the true rate of occurrence of pediatric bipolar disorder?
How does this number compare with the true rate of occurrence of adult bipolar disorder?
With the information you have provided, I don't think you have proven that bipolar disorder is overdiagnosed in any population.
From what I have read recently, there are some researchers who feel that bipolar disorder in pediatric populations is still underdiagnosed. This is an unpopular opinion of the lay public at this point in time.
Some interesting perspectives:
http://www.medscape.com/viewarticle/727955?src=mp&spon=12&uac=41170BN
I am ambivalent regarding whose opinions to place trust in with these issues. I don't have sufficient education to effectively debate them. I am just trying to exercise some cautious skepticism.
- ScottThe measure of achievement lies not in how high the mountain,
but in how hard the climb.The measure of success lies only in how high one feels he must
climb to get there.
poster:SLS
thread:960844
URL: http://www.dr-bob.org/babble/20100908/msgs/962444.html