Questions in psychiatry (QuiP): Is paediatric bipolar disorder a valid diagnosis?

Therefore, it is a tremendous leap to transpose medications from ABCD to PBD where, as discussed, the diagnosis is less robust, and it is completely unknown whether the underlying emergent pathology is in any way similar to that found later in adulthood once the disease is established. Thus, assigning PBD disease-status, and doing so without knowing for certain that the diagnosis is indeed a paediatric form of adult bipolar disorder, facilitates the misapplication of treatments in a population that has been inadequately tested for their use, and one that is particularly vulnerable to the long-term effects of pharmacotherapeutic agents on both the brain and the body. In a recent Debate article,1 which was essentially a retort to an article2 in which we had raised the possibility of abandoning the term PBD, Dr Manpreet Singh and her illustrious colleagues vehemently defend the use of the diagnostic label - arguing that the threshold for evidence to inform clinical practice has already been reached, and that as a consequence the term is valid and fit for purpose. [Extracted from the article]