Pediatric Bipolar Disorder: Underdiagnosed or Fiction?

Sahling, Daniel L.

doi:10.1891/1559-4343.11.3.215

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…Once atypicals were ‘proven’ effective for bipolar disease, rates of diagnosis rose dramatically, especially in children. The number of children and adolescents treated for bipolar disorder in the United States rose 40‐fold between 1994 and 2000 [22].…”

Section: Clinical Example: Prescribing Antipsychotics and Antidepressmentioning

confidence: 99%

How evidence‐based medicine is failing due to biased trials and selective publication

Every‐Palmer

Howick

2014

Evaluation Clinical Practice

159

109

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Evidence-based medicine (EBM) was announced in the early 1990s as a 'new paradigm' for improving patient care. Yet there is currently little evidence that EBM has achieved its aim. Since its introduction, health care costs have increased while there remains a lack of high-quality evidence suggesting EBM has resulted in substantial population-level health gains. In this paper we suggest that EBM's potential for improving patients' health care has been thwarted by bias in the choice of hypotheses tested, manipulation of study design and selective publication. Evidence for these flaws is clearest in industry-funded studies. We argue EBM's indiscriminate acceptance of industry-generated 'evidence' is akin to letting politicians count their own votes. Given that most intervention studies are industry funded, this is a serious problem for the overall evidence base. Clinical decisions based on such evidence are likely to be misinformed, with patients given less effective, harmful or more expensive treatments. More investment in independent research is urgently required. Independent bodies, informed democratically, need to set research priorities. We also propose that evidence rating schemes are formally modified so research with conflict of interest bias is explicitly downgraded in value.

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Section: Clinical Example: Prescribing Antipsychotics and Antidepressmentioning

confidence: 99%

How evidence‐based medicine is failing due to biased trials and selective publication

Every‐Palmer

Howick

2014

Evaluation Clinical Practice

159

109

View full text Add to dashboard Cite

show abstract

Pediatric and adolescent mood disorders

Sulley

Ndanga

Mensah

2022

International Journal of Pediatrics and Adolescent Medicine

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Background: Mental health is an essential aspect of health and wellbeing that the general population often overlooks. This study aims to utilize a nationwide sample [Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID)] to analyze the factors affecting inpatient mood disorder admissions in the United States. Methods: A total of 295,472 cases ages 1–20 were identified to meet the criteria (Appendix A) for the selected mood disorders from the HCUP KID 2016 dataset. We conducted descriptive statistics of the individual diagnosis. We evaluated the relationships with variables such as age (grouped), sex, region, disposition, household income, race, rural-urban demographics, and mean charges. We also conducted association tests for the variables of interest. Results: An average of six days LOS was observed for mood disorders compared to four days LOS for other pediatric inpatient admissions nationwide. The highest prevalence rate (per 100,000) of single (5050), recurrent (2284) episode MDD and bipolar disorder (2445) was observed among no charge (uninsured) populations. The native American population had the highest rate prevalence of single episode MDD (3274) and highest extreme and significant loss of function at presentation. The highest manic episode presentation rate was observed among Black (12) and Native American (9) populations. Manic episodes and bipolar disorder were higher among young adults (47 and 4554); teenagers (13–17) showed a higher presentation rate for all other mood disorders. Conclusion: No charge (uninsured), teenagers (13–17), females, native Americans, and south and midwest regions showed a higher rate of mood disorder presentations among the population. Understanding these variances could play a vital role in highlighting the need for new innovative care approaches. Comprehensive mental health programs in collaboration with educational and community organizations and other stakeholders could be vital to addressing mood and mental health among these populations. This approach tackles several social influencers such as stigma and support to ensure effectiveness and sustainability.conclusion.

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Pediatric Bipolar Disorder: Underdiagnosed or Fiction?

Cited by 2 publications

References 32 publications

How evidence‐based medicine is failing due to biased trials and selective publication

How evidence‐based medicine is failing due to biased trials and selective publication

Pediatric and adolescent mood disorders

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