++Over 81% of youths Took An SSRI or ADHD Med Before Being Diagnosed as Bipolar
Sixth sentence reads: "During the yearbefore the new diagnosis of bipolar disorder, youths were commonlydiagnosed as having depressive disorder (46.5%) or disruptivebehavior disorder (36.7%) and had often filled a prescriptionfor an antidepressant (48.5%),stimulant (33.0%), mood stabilizer(31.8%), or antipsychotic (29.1%]."
Mental Health Treatment Received by Youths in the Year Before and After a New Diagnosis of Bipolar Disorder
Mark Olfson, M.D., M.P.H., Stephen Crystal, Ph.D., Tobias Gerhard, Ph.D., Cecilia S. Huang, Ph.D. and Gabrielle A. Carlson, M.D.
Dr. Olfson is affiliated with the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY 10032 (e-mail: firstname.lastname@example.org ). Dr. Crystal and Dr. Huang are with the Institute for Health, Health Care Policy, and Aging Research, and Dr. Gerhard is with the Ernest Mario School of Pharmacy, both at Rutgers University, New Brunswick, New Jersey. Dr. Carlson is with the Department of Psychiatry and Behavioral Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
OBJECTIVE: Despite a marked increase in treatment for bipolardisorder among youths, little is known about their pattern ofservice use. This article describes mental health service usein the year before and after a new clinical diagnosis of bipolardisorder. METHODS: Claims were reviewed between April 1, 2004,and March 31, 2005, for 1,274,726 privately insured youths (17years and younger) who were eligible for services at least oneyear before and after a service claim; 2,907 youths had newdiagnosis of bipolar disorder during this period. Diagnosesof other mental disorders and prescriptions filled for psychotropicdrugs were assessed in the year before and after the initialdiagnosis of bipolar disorder. RESULTS: The one-year rate ofa new diagnosis of bipolar disorder was .23%. During the yearbefore the new diagnosis of bipolar disorder, youths were commonlydiagnosed as having depressive disorder (46.5%) or disruptivebehavior disorder (36.7%) and had often filled a prescriptionfor an antidepressant (48.5%), stimulant (33.0%), mood stabilizer(31.8%), or antipsychotic (29.1%). Most youths with a new diagnosisof bipolar disorder had only one (28.8%) or two to four (28.7%)insurance claims for bipolar disorder in the year starting withthe index diagnosis. The proportion starting mood stabilizersafter the index diagnosis was highest for youths with five ormore insurance claims for bipolar disorder (42.1%), intermediatefor those with two to four claims (24.2%), and lowest for thosewith one claim (13.8%). CONCLUSIONS: Most youths with a newdiagnosis of bipolar disorder had recently received treatmentfor depressive or disruptive behavior disorders, and many hadno claims listing a diagnosis of bipolar disorder after theinitial diagnosis. The service pattern suggests that a diagnosisof bipolar disorder is often given tentatively to youths treatedfor mental disorders with overlapping symptom profiles and issubsequently reconsidered.
Related Article: August 2009: This Month's Highlights Psychiatr Serv 2009 60: 1009. [Full Text][PDF]