mania for treatment
TRANSCRIPT
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WHEN the prevalence of a medical condition
leaps fivefold in eight years and it is not an
infectious disease, something strange is going
on. That is what has happened to childhood
bipolar disorder in the US. The increase is not
mirrored in other countries and there is no
consensus among US doctors over the cause
of the rise. Alarm bells are ringing.
Bipolar disorder used to be called manic
depression. Over many months patients
swing between extreme emotional highs and
lows. Until a decade ago it was an exclusively
adult disease whose diagnosis required
serious symptoms, including hospitalisation
for mania. Today in the US children as young
as 3 are being diagnosed, often based on the
observations of worried parents.
Suggested reasons for the rise are
many and contentious. They range from
a broadening of the definition of bipolar
disorder, to the trend of viewing everyday
behavioural difficulties as a medical
problem (see page 6). In the background is,
as ever, a pharmaceutical industry that
encourages drugs to be taken up for a broader
range of disorders and by new patient groups
(New Scientist, 15 April 2006, p 38).
There is no doubt that plenty of
misdiagnosis is going on. One US paediatric
psychiatrist told New Scientist that only 18 per
cent of children referred for a second opinion
actually had bipolar disorder. Similar results
are reported by other specialists.
Nor is it a surprise that diagnosis is
difficult. Many of the symptoms of bipolar
disorder are shared with other psychiatric
problems, notably attention deficit
hyperactivity disorder. Children can also have
atypical symptoms: swinging between moods
within an hour, for example.
More worrying is the growing evidence
that children diagnosed with bipolar disorder
do not suffer from the disease as adults,
suggesting that the adult and childhood
conditions are not the same. Despite this,
children with bipolar disorder are given
potent anti-psychotic and anti-convulsant
drugs similar to those used to treat adults.
These come with serious side effects and an
increased risk of premature death.
Do children benefit from their treatment?
Only small studies have been conducted and
the evidence is equivocal, especially for
judging long-term outcomes.
The diagnosis and treatment of bipolar
disorder in American children is evidently
in a mess. It may be that doctors have
identified a group of overlooked children
who would benefit from treatment, but the
evidence is too scant to tell. In the meantime,
children are being given dangerous mind-
altering drugs. For their sake, the doubts
over bipolar disorder needs to be resolved,
and quickly. ●
NICO the robot has joined the illustrious club
of humans, chimps, elephants and dolphins in
being able to recognise himself in a mirror.
Another automaton, Leonardo, now has the
ability to see the world from another’s
perspective – a primitive theory of mind. It
seems that artificial intelligence is at last
making inroads into the things that really
make us human (see page 30).
Or is it? Critics argue that these skills are
just clever parlour tricks and that even a slight
change in the robots’ situations while they
perform these tasks will leave them all at sea.
Unlike a chimp or a young child, they are
missing the rest of the consciousness package
that would let them generalise and improvise.
That much is true, but modelling
individual human-like skills has other
values. For example, it can reveal whether
a particular human trait is simple to
reproduce or can only be created by complex
means. It can give cognitive scientists a steer
for how the human brain completes certain
tasks, and most directly it may give robots
useful new talents.
We can expect robots to master other
human hallmarks, from deceit and empathy
to lie detection and even emotions. By
understanding more about how to recreate
these individual traits, the hope is that they
will point researchers towards the glue that
holds them all together: what is needed
to create a conscious entity. Bring on the
happy robot. ●
Marvin the paranoid android may be fiction...
Mania for treatmentAre doctors rushing to judgement over childhood bipolar disorder?
www.newscientist.com 19 May 2007 | NewScientist | 3
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