Summary: | Traditionally bipolar disorder has been seen as extremely rare prior to puberty and very rare in early adolescence, with first onset usually being from mid adolescence into adulthood. Diagnosis is often made late and early detection is important. However since the mid 1990s in the USA the rate of bipolar disorder diagnoses with children and teens has soared (44 fold from 94/95 to 02/03), is not uncommonly diagnosed in children as young as 2 years of age, and is the most common diagnosis in pre-pubertal paediatric psychiatric inpatient units. There is intense controversy over the diagnosis including between proponents of different "paediatric bipolar disorder phenotypes" and from clinicians who hold to traditional views that discount the validity of "Paediatric Bipolar Disorder" (PBD).
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