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Paediatric Bipolar?

The Letter, Issue 46, Spring 2011, Pages 47 - 56


Lionel Bailly

Between 1994 and 2003 the number of outpatient pediatric psychiatry visits associated with the diagnosis of Bipolar Disorder in the USA apparently increased 40-fold. Such an increase was not supported by any new research evidence and illustrated a shift of professional towards a purely organic model of child behaviour. The preparation of DSM 5 showed a return to a more psychological model of disturbances in children with the introduction of a new disorder: Temper Dysregulation Disorder with Dysphoria. However, psychoanalytical models can provide a deeper understanding of the process leading to the observed symptoms.

Key words: Paediatric Bipolar; Temper Dysregulation Disorder with Dysphoria; paternal metaphor; enjoyment; psychoanalysis.

This presentation is going to be marked by my scepticism towards some aspects of what has been called Paediatric Bipolar, a Disorder that will not be included in DSM 5 and I'm going to try to justify this scepticism through the examination of clinical features described in children. This attitude is probably a consequence of my training as a clinician, a child psychiatrist and a psychoanalyst.

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