Is bipolar II disorder misdiagnosed as major depressive disorder in children?
OBJECTIVE
To estimate the lifetime prevalence of bipolar II disorder in children and adolescents presenting with DSM-IV major depressive disorder (MDD).


METHODS
Sixty-one consecutive subjects aged < or =18 years attending the outpatient services of the Child and Adolescent Psychiatric (CAP) services of the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India with a diagnosis of MDD were evaluated using the Missouri Assessment of Genetics Interview for children (MAGIC). Two psychiatrists, one of whom was a child psychiatrist diagnosed hypomania by consensus.


RESULTS
Twelve children had a past episode of hypomania (20%), which was hitherto undiagnosed clinically.


CONCLUSIONS
We recruited subjects from a psychiatric hospital, thus limiting the generalizability of the finding. Sample size was relatively small and assessments were cross-sectional.


CONCLUSIONS
: Our study shows that bipolar II disorder is often misdiagnosed as MDD in children. The study also highlights that the chance of diagnosing bipolarity is enhanced by using semi-structured interview in routine clinical practice.
Bhargava Raman
R P
RP
Department of Psychiatry, National Institute of Mental health and Neurosciences (NIMHANS), Bangalore 560029, India.
Sheshadri
S P
SP
Janardhan Reddy
Y C
YC
Girimaji
S C
SC
Srinath
S
S
Raghunandan
V N G P
VN
D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis*; D002648:Child; D003430:Cross-Sectional Studies; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D013997:Time Factors