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Paediatric bipolar disorder: international comparisons of hospital discharge rates 2000-2010

Joe Clacey1, Michael Goldacre2, Anthony James3

  • 1, BM, BCh BA (Hons), Highfield Unit, Warneford Hospital, Oxford.

Bjpsych Open
|October 6, 2016
PubMed

Insights

Paediatric bipolar disorder discharge rates vary significantly worldwide, with the USA showing substantially higher rates than other developed nations. This suggests potential differences in diagnostic practices for child bipolar disorder.

Area of Science:

  • Child and Adolescent Psychiatry
  • Global Health Epidemiology
  • Mental Health Services Research

Background:

  • Diagnosis and prevalence of paediatric bipolar disorder are subjects of ongoing international debate.
  • Estimates of paediatric bipolar disorder vary considerably across different countries, highlighting a need for comparative analysis.

Purpose of the Study:

  • To compare international hospital discharge rates for paediatric bipolar disorder.
  • To contrast these rates with those of all other psychiatric diagnoses in children and adolescents.

Main Methods:

  • Utilized national datasets from England, Australia, New Zealand, the USA, and Germany.
  • Analyzed data spanning the years 2000 to 2010.
  • Focused on hospital discharge rates for individuals under 20 years of age.

Main Results:

  • Discharge rates per 100,000 population for paediatric bipolar disorder (under 20) were: USA 95.6, Australia 11.7, New Zealand 6.3, Germany 1.5, and England 0.9.
  • The most significant divergence was observed in 5- to 9-year-olds, with rates of USA 27, New Zealand 0.22, Australia 0.14, Germany 0.03, and England 0.00.
  • The disparity in US rates for paediatric bipolar disorder was notably greater than for overall child psychiatric diagnoses or adult bipolar disorder.

Conclusions:

  • A substantial disparity exists between US and other countries' discharge rates for paediatric bipolar disorder.
  • This significant variation suggests potential differences in diagnostic practices for paediatric bipolar disorder, particularly in the USA.
  • Further research is warranted to understand the drivers behind these international diagnostic variations.
Abstract

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