Mental Health Blogs

From time to time, I simply shake my head at the quality of health journalism in the US, particularly as regards children’s mental health. Today’s example comes to us from the San Francisco Chronicle in an article entitled “Antipsychotic drugs for kids raise hope, worry.” While the article does get at both the hope and worry around the use of these drugs in kids, it remains uncomfortably biased toward promoting the use of antipsychotics in kids to the point where you’ve got to wonder who the reporter’s sources were and who the hell is editing at the Chron these days.

The trouble starts in the lede:

“Increasingly powerful antipsychotic drugs available on the market, and growing evidence that starting these medications early can help children with conditions like bipolar disorder, is putting doctors under more pressure than ever to diagnose and treat young people with mental illnesses.

“As a result, some doctors say, mental illness, especially bipolar disorder, has been overdiagnosed much the same way attention deficit hyperactivity disorder was in the 1980s.”

OK, how would the availability of a drug put docs under pressure to diagnose and treat people? What growing evidence that starting these medications early helps children with alleged bipolar disorder? Certainly, the article offers no evidence and, to date, there’s no long term “evidence” to support the use of these drugs in kids and the shorter-term studies aren’t particularly conclusive either. But there it is in black and white and you’ve got wonder if there’s a skeptical eye at the paper at all, especially when we’re talking about a diagnosis–pediatric bipolar disorder–that is deeply controversial within child psychiatry itself when applied to kids younger than 12 or so.

And the antipsychotics are “increasingly powerful?” Compared to what? Older antipsychotics? Really? That’s a statement that makes no sense.

The article does a decent job of talking about of overdiagnosis of bipolar disorder in kids and teens and fleshes out some docs’ concerns about misdiagnosis, but at core the paper completely accepts the validity of the disorder in children and then sets about quoting a NAMI official:

“Dale Milfay, vice president of the National Alliance on Mental Illness in San Francisco, said it’s crucial that children with mental illness get a correct diagnosis as soon as possible and start treatment right away. There may be medical advantages to early treatment, she said, but children also benefit from staying in school and developing crucial relationships with friends and family.

“‘The earlier people are diagnosed, the better their chances,’ Milfay said. “‘But you wouldn’t want these drugs to be overused. There needs to be some real criteria that this is not something a primary care doctor can just diagnose.’”

While I appreciate someone from pharma-funded NAMI striking a cautionary note, I’d really love knowing where their evidence is of early diagnosis being crucial to child development, especially when you have some experts in child psychiatry who claim that kids who get hit with bipolar diagnoses as kids don’t wind up having bipolar disorder as adults.

Like I said above, I sure do wonder about the state of health care journalism these days and my concern isn’t idle given that health care comprises about 25 percent of the American economy these days.

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Related posts:

1. JAMA Study Finds Explosive Weight Gain In Kids On Antipsychotics
2. Study: Medicaid Kids Get Antipsychotics At Four Times The Rate Of Privately-Insured Kids
3. Perspective On Antipsychotics For Kids FDA Panel Recommendation
4. FDA Panel Recommends Approval Of Antipsychotics For Kids Aged 10, Older
5. FDA Dubs Antipsychotics For Kids Effective With Substantial Risks