Higher discharge rate for BPD in children and adolescents in the US compared to UK

Reports a comparative study published in the Journal of the American Academy of Child and Adolescent Psychiatry

2014-05-22

(Press-News.org) Washington D.C., May 22, 2014 – A study published in the June 2014 issue of the Journal of the American Academy of Child and Adolescent Psychiatry found a very much higher discharge rate for pediatric bipolar (PBD) in children and adolescents aged 1-19 years in the US compared to England between the years 2000-2010.

Using the English NHS Hospital Episode Statistics (HES) dataset and the US National Hospital Discharge Survey (NHDS) to compare US and English discharge rates for PBD over the period 2000-2010, the authors found a 72.1-fold higher discharge rate for pediatric bipolar in youth in the US compared to England. After controlling for cross-national differences in length of stay, discharge rates for PBD remained 12.5 times higher in the US than in England, and for all other child psychiatric diagnoses the discharge rate was 3.9 higher, and for adults with BD 7.2 fold higher, in the US than in England.

Dr. Anthony James, with the University of Oxford, and lead author of the paper, said of the study, "The finding that the disparity between US and English discharge rates for PBD is markedly greater than the disparity for child psychiatric discharge rates overall, and for adult rates for bipolar disorder, is potentially important. However, the study design does not allow us to answer the question whether US clinicians are too liberal in assigning the diagnosis of bipolar disorder to youth or, alternatively, whether English clinicians fail to recognize or diagnose these illnesses. It is clear that the reasons for the disparity in the case of PBD warrant further study."

INFORMATION: The article "A Comparison of American and English Hospital Discharge Rates for Pediatric Bipolar Disorder, 2000-2010" by Anthony James, M.D., Uy Hoang, M.D., Valerie Seagroatt, M.Sc., Joe Clacey, M.D., Michael Goldacre, M.D., Ellen Leibenluft, M.D., appears in the Journal of the American Academy of Child and Adolescent Psychiatry, Volume 53, Issue 6 (June 2014), published by Elsevier.

A related editorial, "Unpacking the Differences in US-UK Rates of Clinical Diagnoses of Early Onset Bipolar Disorder," by Drs. Argyris Stringaris and Eric Youngstrom, is published in the same issue.

Funding: The English National Institute for Health Research funds the Unit of Health-Care Epidemiology to undertake research using the English national dataset.

Notes for editors Full text of the article is available to credentialed journalists upon request; contact Mary Billingsley at +1 202 587 9672 or mbillingsley@jaacap.org. Journalists wishing to interview the authors may contact Anthony James, at anthony.james@psych.ox.ac.uk

All articles published in JAACAP are embargoed until the day they are published as in press corrected proofs online at http://jaacap.org/inpress. Articles cannot be publicized as in press accepted manuscripts. Contents of the publication should not be released to or by the media or government agencies prior to the embargo date.

About JAACAP Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world-leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact Mary Billingsley
JAACAP Editorial Office
+1 202 587 9672
mbillingsley@jaacap.org

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