Monday, February 18, 2008

Childhood bipolar disorder

This weekend there was an article in the Globe and Mail talking about the increasing prevalence of childhood bipolar disorder. The whole thing did not sit well with me, so below is a letter I sent to the editor in hopes it will be published. If not, at least you will read it!

Since research and development is so expensive, a new tactic used by pharmaceutical companies to increase revenue is to 'invent' medical conditions or to 'redefine' an existing medical condition so that existing drugs are used more frequently. The most glaring example of this is pre-menstrual dysphoric disorder. Similar to childhood bipolar disorder, it is a condition nonexistent in Europe and although it is recognized as a psychiatric disease in the diagnostic manual used by North American psychiatrists, it is not considered as a disease by the World Health Organization International Classification of Diseases. Is this happening here? Joseph Biederman, mentioned in this article as a supporter of this new diagnosis, has received research support from or served on a speaker's bureau or advisory board of fourteen drug companies. As for the Canadian Attention Deficit/Hyperactivity Disorder Alliance Resource, questions should be asked about their main sources of sponsorship. The only three sponsors listed on their website are Eli Lilly, Janssen-Ortho, and Shire. Lilly makes Strattera, a popular ADHD drug and one being pushed for use in another "new" disease, adult ADHD. Janssen-Ortho makes Concerta, one of the top selling forms of methylphenidate, previously known only as Ritalin. Shire makes Adderall XR, another ADHD drug. The bottom line is that psychiatry is a field into which the tendrils of pharma penetrate deeply. Careful when searching for information in this field as a layperson. When all else fails, look to Europe for guidance. For some reason they seem to be immune to this whole mess.

What do you think of this issue? Is Childhood Bipolar Disorder a legitimate condition? Does Pharma have too much influence on disease definitions? Have your say by leaving a comment.

1 comment:

Anonymous said...

I think it is over-diagnosed. As is ADHD. People are too quick to label kids and drug them rather than look into the underlying cause of their behaviour issues.