Aiming to gain a better understanding of the public’s perceptions of bipolar disorder, a recent survey revealed that only 11% of adults believe the illness can occur at any age and only 40% believe it is hereditary—two common misperceptions that may lead to misdiagnosis in children, according to researchers who presented their findings at the Child & Adolescent Bipolar Foundation (CABF) annual board of directors meeting.

The research firm StrategyOne polled 1,000 American adults (ages 18 and older) about bipolar disorder during nationwide telephone interviews in May 2003. A total of 788 respondents who declared they were aware of bipolar disorder were interviewed in depth about its symptoms, causes, and the effects of treatment. The findings within each of the population segments include a margin of sampling error of ± 3.1 percentage points for the larger segment and ± 3.5 points for the smaller segment.

CABF included the same questions in its 2003 annual membership survey, whose respondents included parents of children diagnosed with bipolar disorder or parents of children who showed symptoms of the illness. CABF e-mailed the survey to 9,645 of its members and conducted all survey research and analysis during June 2003. CABF received 1,862 responses from members, of whom 1,526 (83%) stated that they are parents of children who have been diagnosed with bipolar disorder. Key findings between the two surveys were then analyzed to acquire comparative results.

PUBLIC PERSPECTIVES

The differences in findings indicated a gap in understanding of the prevalence, nature, and consequences of bipolar disorder, as shown by the following statistics:
• Of the 788 adults surveyed who were aware of bipolar disorder, only 11% believed that the illness can occur at any age, while 58% indicated it can occur only in adults. However, CABF estimates that more than 750,000 children and adolescents in the United States have bipolar disorder and can exhibit symptoms as early as preschool.
• Bipolar disorder is hereditary: While only 40% of those surveyed recognized bipolar disorder as a hereditary condition, the majority identified illnesses such as breast cancer (60%), coronary heart disease (67%), and diabetes (77%) as genetic.

According to CABF, however, bipolar disorder is a highly genetic medical condition that may be linked to chemical imbalances and structural differences in the brain. “Bipolar disorder is a hereditary illness, and the belief that it is caused by bad parenting leads to the stigmatization of children and families. While stress of any kind might aggravate the illness, most affected children are genetically predisposed to bipolar disorder and often develop symptoms without any observable triggers,” said Martha Hellander, Executive Director of CABF.

ADDITIONAL MISCONCEPTIONS

Other key findings from those who were familiar with bipolar disorder revealed factors that might contribute to the general misunderstandings surrounding the illness:
• Only 16% of Americans familiar with the illness strongly understood the similarities between attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder. However, when asked the same question about the CABF estimate that more than one in 10 children diagnosed with ADHD also displays symptoms of bipolar disorder, 65% of CABF members were aware of the similarities. “Because ADHD is more common, both parents and doctors might overlook bipolar disorder as a possible diagnosis,” Ms. Hellander said.
• Only 29% of those surveyed strongly identified bipolar disorder as a life-threatening illness. Most (57%) understood that the risk of substance abuse in people diagnosed with bipolar disorder is 10 times higher than in the general population. However, 72% of CABF members knew that there is a high morbidity and mortality associated with the disease. Although many of those surveyed who were familiar with the disorder were not aware of the severity of bipolar disorder, 82% understood that the illness worsens without support or treatment.

THE IMPORTANCE OF EARLY RECOGNITION

“The major discrepancies between what people in the general public believe and what research data show about bipolar disorder can have serious consequences, such as adults failing to recognize symptoms in their children, which could lead to delaying appropriate treatment. The survey results indicate there is a great need to educate parents and doctors about treatment and convey the benefit it provides,” Ms. Hellander said.

“When children lose a year or more of their life to bipolar illness, they suffer major setbacks in school, family, and the community. It is important to keep children on track for normal social and behavioral development, which begins with early identification of symptoms and treatment,” she noted.

Suggested Reading
Craney JL, Geller B. A prepubertal and early adolescent bipolar disorder-I phenotype: review of phenomenology and longitudinal course. Bipolar Disord. 2003;5:243-256.
Wagner KD. Management of bipolar disorder in children and adolescents. Psychopharmacol Bull. 2003;36:133-150.

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