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Increase in out-based physician diagnoses of bipolar disorder in youth in the USA

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Mark Olfson

Correspondence to: Mark Olfson, MD, MPH, Department of Psychiatry, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA;



How do patterns of outpatient visits with a diagnosis of bipolar disorder differ between 1994 and 2003 for youths and adults?


Representative sample of people visiting out-based physicians in the USA. Data were collected through the National Ambulatory Medical Care Survey (NAMCS), an annual survey which samples a nationally representative group of visits to doctors engaged in direct patient care.


Out-based physicians across the USA; 1994–2003.


As part of the NAMCS, for one week during the year selected physicians completed a questionnaire about each patient visit (collecting demographic, clinical and treatment characteristics). To look at temporal trends in visits with a diagnosis of bipolar disorder, researchers pooled data for the following years: 1994–5, 1996–7, 1998–9, 2000–1, and 2002–3. Trends were compared in two different age groups, 0–19 year olds (youths) and 20+ year olds (adults).


Visits per 100 000 population at which a diagnosis of bipolar disorder (ICD-9-CM) was received, proportion of visits …

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