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Notes: Response rates over the years ranged from 70% to 73%. Diagnoses of mental illnesses were based on the judgement of the treating physician. The NAMCS records visits made rather than individual patients, so there may be double counting for some people. The study is also limited by only recording visits to out-based physicians not in other centres (for example, community mental health centres, hospitals, etc) where bipolar disorders may present. The authors put forward two hypotheses to explain the increase in diagnoses: firstly that bipolar disorder is no longer under-diagnosed as it might have been historically or that it is now being over-diagnosed in this age group.
Source of funding: Alicia Kaplowitz Foundation Fellowship in Child and Adolescent Psychiatry, the Spanish Ministry of Health, Instituto de Salud Carlos III, Red de Enfermedades Mentales, and National Institutes of Mental Health, National Institutes of Health, US Department of Health and Human Services.
Competing interests: In the preceding five years, JCB has received research and travel support from Abbott Laboratories Inc, and travel support from Otsuka America Pharaceutical Inc.
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