The Relationship Between Pediatric Bipolar Disorder and Inpatient Readmission Interval Length

Dolores Kane (2009)

The purpose of this study was to explore the relationship between the diagnosis of pediatric bipolar disorder in adolescents and the length of interval between subsequent inpatient hospitalizations over a six-year period. Using archival data, 263 (n = 263) adolescent male and female patient records were examined. The central hypothesis was that adolescents diagnosed with pediatric bipolar disorder would have a shorter interval between subsequent admissions to inpatient treatment than adolescents diagnosed with other disorders. The three primary factors that provided context for this study were (a) increased attention and diagnosis of pediatric bipolar disorder, (b) the need to provide more effective treatment for adolescents with bipolar disorder, and (c) the impact of cost on mental health treatment. Developing a better understanding of bipolar disorder in children and adolescents would result in more timely and appropriate treatment that could potentially decrease individual and family stress and increase diagnostic sensitivity. Analysis of Variance (ANOVA) was the initial inferential statistical test used to compare four DSM Axis I diagnoses groups of: (a) Bipolar I Disorder (n = 43); (b) Major Depressive Disorder, Recurrent, Severe (n = 140); (c) Mood Disorder, Not Otherwise Specified (n = 46) and (d) Posttraumatic Stress Disorder (n = 34). Descriptive statistics used included range, mean and median, frequency of all groups, age and primary Axis I diagnoses. The second analysis consisted of using the nonparametric Kruskal-Wallis one-way analysis of variance test because initial findings revealed positively skewed data that was unimodal. The study found that the Posttraumatic Stress Disorder group’s readmission interval was significantly shorter than the Bipolar I Disorder group and Major Depressive Disorder group. The Bipolar I Disorder did not return with more frequency to an inpatient psychiatric unit. Results showed that 16 years of age was the age group most frequently represented for readmission during a six-year period. The scope of the study would have been enhanced by the inclusion of more identifying variables such as a history of patient’s previous hospitalizations, one’s insurance coverage and the amount of time it took for patients to return to an inpatient psychiatric setting. Collecting data within a shorter window of time may have provided a better view of which diagnoses were readmitted most frequently. The study was also unable to pinpoint the exact age at which a child or adolescent received the diagnosis of bipolar disorder, therefore could not detect if the diagnosis remained stable over the course of several years. Lithium is the only FDA-approved medication for bipolar disorder in children 12 years and older. More studies are needed regarding medication interventions and the potentially adverse side effects of medication use in children and adolescents.