Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis

202 Pages·2011·3.704 MB·English

by  Stuart L Kaplan M.D.

Your Child Does N ot
Have Bipolar Disorder
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Your Child Does N ot
Have Bipolar Disorder
How Bad Science and Good Public
Relations Created the Diagnosis
Stuart L. Kaplan, MD
Childhood in America
Sharna Olfman, Series Editor
Copyright 2011 by Stuart L. Kaplan, MD
All rights reserved. No part of this publication may be reproduced, stored in a retrieval sys-
tem, or transmitted, in any form or by any means, electronic, mechanical, photocopying, re-
cording, or otherwise, except for the inclusion of brief quotations in a review, without prior
permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data
Kaplan, Stuart L.
Your child does not have bipolar disorder : how bad science and good public
relations created the diagnosis / Stuart L. Kaplan.
p. cm. — (Childhood in America)
Includes bibliographical references and index.
ISBN 978-0-313-38134-8 (hard copy : alk. paper) — ISBN 978-0-313-38135-5 (ebook)
1. Manic-depressive illness in children—Popular works. I. Title. II. Series.
RJ506.D4K37 2011
618.92’895—dc22 2010047612
ISBN: 978-0-313-38134-8
EISBN: 978-0-313-38135-5
15 14 13 12 11 1 2 3 4 5
This book is also available on the World Wide Web as an eBook.
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ABC-CLIO, LLC
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This book is printed on acid-free paper
Manufactured in the United States of America
To Joan Kaplan, my wife and soul mate, and to
Lawrence Kaplan, my son and good friend
In memory of my father, mother, and brother:
Leonard Kaplan, Anne Kaplan, and Philip B. Kaplan

Contents
Acknowledgments xi
Introduction xiii
PART I. CRITIQUE OF PEDIATRIC BIPOLAR DISORDER
1 Adult Bipolar Disorder and the DSM System 3
Adult Bipolar Disorder 4
The DSM System 8
2 Pediatric Bipolar Disorder 15
Pediatric Bipolar Disorder as ADHD and ODD 17
The Development of the Diagnosis of Pediatric
Bipolar Disorder 24
Bipolar Disorder in the Very Young 32
One Authoritative View 35
3 Some Studies of the Scientifi c Basis of Pediatric
Bipolar Disorder 39
Genetics 40
Age of Onset: Family Studies 43
Age of Onset: Self-Report 46
Epidemiology 48
Treatment or Prevention? 50
viii CONTENTS
4 Cultural Infl uences in Pediatric Bipolar Disorder 55
How Culture Helps Shape Mental Illness 56
Pediatric Bipolar Disorder as a Media Event 58
Professional Support for the Diagnosis 64
Psychological Consequences of Misdiagnosis 68
Conclusion 71
5 Child and Adolescent Depression: A Brief Introduction 75
Diagnosing Depression in Children and Adolescents 76
The Diagnosis of Depression in Children and Adolescents
and DSM-IV Criteria 77
Suicide 81
Depression and Bipolar Disorder 82
Conclusion 82
6 Did Romeo and Juliet Have Bipolar II Disorder?
Bipolar Disorder in Adolescence 83
Romeo and Juliet 83
Aggression and the Misdiagnosis of Bipolar Disorder in
an Adolescent 85
Bipolar Disorder in an Adolescent 86
Conclusion 88
PART II. MEDICATIONS AND
PEDIATRIC BIPOLAR DISORDER
7 Three Medications for Pediatric Bipolar Disorder 93
Lithium 94
Valproate 97
Risperidone 99
Conclusion 103
8 Clinical Trials 109
A Change in Clinical Child Psychiatry 110
Introduction to Clinical Trials 112
Multisite Clinical Trials 113
Example of a Clinical Trial 115
Conclusion 120
9 Bad Science 121
The Importance of Falsifi cation 122
Diagnostic Errors 123
Mixing Apples and Oranges 126
Chicken or Egg? 126
Conclusion 127
CONTENTS ix
10 Stimulant Medications 129
Ethical Considerations 130
Increase of Use in Stimulant Medication 132
The MTA Study 134
Stimulant Risks 139
Conclusion 146
PART III. ADVICE FOR PARENTS
11 Medication Advice for Parents 153
Stimulant Medications 153
Antipsychotic Medications 155
12 A Family-Based Behavior Modifi cation Program
for Oppositional Children 157
Reinforcing Bad Behavior 158
The Behavior Modifi cation Program: An Overview 160
Stage I: Rewards List 162
Stage II: Misbehavior List 164
Stage III: Baseline Data 165
Stage IV: Implementation 166
Family Therapy Considerations 169
For Parents Only 172
Afterword by Sharna Olfman, PhD 173
Index 175