Transcript Tristin Pfeifer CHHS 302 Collaborative Health and

United States
Food and Drug
Administration
Incentivized Medicine
and Misdiagnosis of
Pediatric Bipolar
Disorder (PBD)
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By Tristin Pfeifer
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
Rhetorical Timing
• Negative effects on
child's/adolescent
health
• Worrisome spike in a
particular diagnosis
• Clonidine causes death
of 2 year old (Kaplen,
2011)
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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)
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)
Pharmaceutical Spending
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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.
Questions?
[email protected]
Image References
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https://encryptedtbn1.gstatic.com/images?q=tbn:ANd9GcRP6Q5kixwgWcidqwCVHf6hdg27i6I
VR9FvtgmYoC9wD4NtnGTB
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_B
riefs/rxp-chart2.jpg
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-prescriberspharmaceutical-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