Bipolar Disorder

Is the compulsion to hoard things a mental disorder? How about the practice of eating excessively at night? And what of Internet addiction: Should it be diagnosed and treated? As the clock ticks toward the release of the most influential of mental health textbooks, psychiatrists are asking themselves thousands of complex and sometimes controversial questions. The answers will determine how Americans' mental health is assessed, diagnosed and treated.

A study of 54 people with bipolar disorder found that the illness, long considered an adult affliction, also affects children. The research, published in Archives of General Psychology this week, said that 44% of those who had manic episodes as children continued having them as adults. "Children with mania grow into adults who have mania," said Dr. Barbara Geller of Washington University School of Medicine in St. Louis, who led the National Institutes of Health-funded study.

'I need these pills refilled," the weary mother says, displaying an array of empty bottles on the desk in my office. "My son is bipolar." The boy, a quiet slip of a 10-year-old, had been prescribed two antipsychotics, two mood stabilizers, one antidepressant, two attention deficit disorder medications and another medication to manage the side effects of the antipsychotics. The mother explained that she had just regained custody of her son and his brother.

Antidepressants, which are widely prescribed with mood stabilizers to treat patients with bipolar disorder, do not work in relieving the depressive symptoms of the illness, a large federal study reported Wednesday. The study in the New England Journal of Medicine narrows the already limited number of treatments for bipolar disorder, which affects 5.7 million adults in the U.S., experts said. "A new generation of drugs is needed," said Dr. Thomas R.

The diagnosis of bipolar disorder in children and adolescents has risen fortyfold since 1994, according to a study released Monday. But researchers partly attributed the dramatic rise to doctors over-diagnosing the serious psychiatric disorder. The report in the journal Archives of General Psychiatry said bipolar disorder was found in 1,003 of every 100,000 office visits from children and adolescents in 2002-03, compared with 25 of 100,000 office visits in 1994-95.

Sales for children of antipsychotic medicines made by Johnson & Johnson, AstraZeneca and Pfizer Inc. have exploded, fueled by a fortyfold increase over nine years in the number of children diagnosed with bipolar disorder. The number of prescriptions for children doubled to 4.4 million from 2003 to 2006, according to data provided to Bloomberg by Wolters Kluwer, a drug-tracking company.

Hour after hour, Christina Eilman threw herself at the bars of her cell, shrieking threats one moment and begging for help the next. Even the women in adjoining cells, many of whom were used to the chaos of lockup, called out to guards on Eilman's behalf. "I heard that girl screaming for her life, 'Take me to the hospital! Call my parents!' " Tamalika Harris, 26, said in an interview. "The way she was screaming and kicking on the bars, I knew something was wrong."

Retired Marine Capt. Rick Duncan carried a list of phone numbers of those in the business of helping veterans. One was for the VA clinic in Colorado Springs, and in 2008 he pressed it upon Mike Flaherty, a young Army veteran struggling with depression. He understood, Duncan told Flaherty. He'd been to Iraq three times. Attacked in Fallouja, he'd returned home with a metal plate in his head and a diagnosis of post-traumatic stress disorder.

A self-described schizophrenic who posed as a wounded Marine captain and advocated for veterans' causes for more than a year before he was unveiled as a fraud was arrested Friday in San Diego, federal officials reported. Rick Glen Strandlof, 32, will be charged with making false claims about the receipt of military medals, a misdemeanor under the Stolen Valor Act, a three-year-old law that criminalizes either wearing or claiming to have a medal that one did not earn. If convicted, he faces a maximum penalty of one year in prison and a $250,000 fine.