J. Clin. Med. 2014, 3(1), 310-322; doi:10.3390/jcm3010310

Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities

1email, 1,* email, 1email and 2email
Received: 13 December 2013; in revised form: 5 February 2014 / Accepted: 11 February 2014 / Published: 20 March 2014
(This article belongs to the Special Issue Bipolar Disorder in Children and Adolescents)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: The diagnosis of pediatric bipolar disorder (PBD) has increased dramatically in community-treated youth in the past 20 years. No previous study has assessed the trend in PBD subtype diagnoses or the impact of clinician-reported behavioral comorbidities (BC) on psychotropic medication prescribing patterns. This study aims: (1) to characterize national trends in PBD visits in relation to PBD subtypes; and (2) to assess differences in socio-demographic PBD subtype diagnostic patterns and psychotropic medications prescribed in PBD visits with and without behavioral comorbidities (w/w/o BC). PBD visits for 1999–2010 from the National Ambulatory Medical Care Survey (NAMCS) data were assessed using population-weighted chi-square and logistic regression analyses. While PBD visit rates were stable across 12 years, the proportional shift of subtype diagnosis from Bipolar I (89.0%) in 1999–2002 to Bipolar Not Otherwise Specified (NOS) (74.1%) in 2007–2010 was notable. Compared with PBD without behavioral comorbidities (w/o BC), PBD visits w/BC had greater proportions of the bipolar-NOS subtype, more males, 2–14-year-olds, and more publicly-insured visits. The prescription of antipsychotics (60% vs. 61%) was common in PBD visits regardless of the presence of behavioral comorbidities. Stimulants were the predominant class prescribed for PBD visits with BC (67.8% vs. 9.4%). Antidepressants were significantly greater in PBD visits without BC (41.6% vs. 21.0%). Overall one-third of PBD youth visits were prescribed antipsychotics concomitant with other psychotropic classes. Behavioral conditions accompanying PBD visits were prominent, suggesting the need for monitoring and evaluating the outcomes of complex medication regimens in community populations.
Keywords: pediatric bipolar disorder; behavioral comorbidities; psychotropic medication; antipsychotics; stimulants; antidepressants
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MDPI and ACS Style

Rajakannan, T.; Zito, J.M.; Burcu, M.; Safer, D.J. Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities. J. Clin. Med. 2014, 3, 310-322.

AMA Style

Rajakannan T, Zito JM, Burcu M, Safer DJ. Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities. Journal of Clinical Medicine. 2014; 3(1):310-322.

Chicago/Turabian Style

Rajakannan, Thiyagu; Zito, Julie M.; Burcu, Mehmet; Safer, Daniel J. 2014. "Pediatric Bipolar Disorder: Subtype Trend and Impact of Behavioral Comorbidities." J. Clin. Med. 3, no. 1: 310-322.

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