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Incentivized Medicine and Mis d iagnosis of Pediatric Bipolar Disorder (PBD)

Incentivized Medicine and Mis d iagnosis of Pediatric Bipolar Disorder (PBD). By Tristin Pfeifer. United States Food and Drug Administration. Image 1. Critical S ituation.

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Incentivized Medicine and Mis d iagnosis of Pediatric Bipolar Disorder (PBD)

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  1. Incentivized Medicine and Misdiagnosis of Pediatric Bipolar Disorder (PBD) By Tristin Pfeifer United States Food and Drug Administration Image 1

  2. Critical Situation Pediatric Bipolar Disorder went from being rarely diagnosed up until the 1990’s to being the most frequent (Littrell & Lyons 2010) It became a trendy diagnosis and a result of incentivized medicine (Littrell & Lyons 2010) Considered a severe mental disorder Medications not approved for children

  3. Rhetorical Timing Negative effects on child's/adolescent health Worrisome spike in a particular diagnosis Clonidine causes death of 2 year old (Kaplen, 2011) Image 2

  4. Causes • Media Attention (Littrell & Lyons 2010) • Pressure to give clinical diagnosis (Spiegel, 2010) • Too broad/vague diagnostic tools (As cited by Jenkins, Youngstrom, & Washburn, 2011). • Pharmaceutical Companies (Frances, 2012)

  5. Effects • Over diagnosis of PBD due to being “trendy”(Littrell & Lyons 2010) • Children taking potentially harmful pharmaceuticals (As cited by Jenkins, Youngstrom, & Washburn, 2011). • Incentives for Clinicians (Littrell & Lyons 2010)

  6. Pharmaceutical Spending Image 3

  7. Solutions • Updates to Diagnostic and Statistical Manual of Mental Disorders (DSM) • Improve Parent awareness • Mandatory reporting of any cases of children prescribed dangerous medications • Mandatory reporting of any financial exchange between pharmaceutical companies and clinicians.

  8. Questions? tpfeifer@csumb.edu

  9. Image References Image 1 https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRP6Q5kixwgWcidqwCVHf6hdg27i6IVR9FvtgmYoC9wD4NtnGTB Image 2 http://newsblaze.com/pix/2008/0820/pix/History-of-Bipolar-Disorder-.jpg Image 3 http://www.pewhealth.org/uploadedImages/PHG/Content_Level_Pages/Issue_Briefs/rxp-chart2.jpg

  10. References Frances, A. (2012, April 3). The False Epidemic of Childhood Bipolar Disorder. Retrieved from HuffingtonPost: http://www.huffingtonpost.com/allen-frances/children-bipolar-disorder_b_1213028.html Instruments in the Application of DSM-IV-TR Criteria for Pediatric Bipolar Disorder. Journal Of The American Academy Of Child & Adolescent Psychiatry,51(6), 605-621 Galanter, C., Hundt, S., Goyal, P., Le, J., & Fisher, P. (2012). Variability Among Research Diagnostic Interview Jenkins, M. M., Youngstrom, E. A., & Washburn, J. J. (2011). Evidence-Based Strategies Improve Assessment of Pediatric Bipolar Disorder by Community Practitioners. Professional Psychology, Research And Practice, 42(2), 121-129 Lance, Jeffrey, I., Boris, Michael, Shirley, Bettina, B., . . . Martin. (2013). Manic symptoms in youth with bipolar disorder: Factor analysis by age of symptom onset and current age. Journal of Affective Disorders, 145(3), 409-412. doi: http://dx.doi.org/10.1016/j.jad.2012.06.024 Littrell, J., & Lyons, P. (2010). Pediatric Bipolar Disorder: An issue for Child Welfare. Children & Youth Services Review, 32(7), 965-973. Miller, L., & Barnett, S. (2008). Mood lability and bipolar disorder in children and adolescents. International Review of Psychiatry (Abingdon, England), 20(2), 171-176. doi: http://dx.doi.org/10.1080/09540260801889088 PEW. (2013, January). Persuading the prescribers: Pharmaceutical Industry Marketing and its influence on Physicains and patients. Retrieved from PEW: http://www.pewhealth.org/other-resource/persuading-the-prescribers- pharmaceutical-industry-marketing-and-its-influence-on-physicians-and-patients-85899439814 Spiegel, A. (2010, Febuary 10). Children Labeled 'Bipolar' May Get A New Diagnosis. Retrieved from National Public Radio: http://www.npr.org/templates/story/story.php?storyId=123544191 Staurt L. Kaplan, M. (2011, June 19). Mommy, Am I Really Bipolar? Retrieved from The daily beast: http://www.thedailybeast.com/newsweek/2011/06/19/mommy-am-i-really-bipolar.html

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