Debate: Pediatric bipolar disorder – divided by a common language?

The paediatric bipolar disorder ( pBD ) debate is seen as a prototypical transatlantic controversy. But this is a Eurocentric view that ignores just how big a country the United States is – it contains multitudes, to paraphrase Walt Whitman writing in the aftermath of the Civil War. Indeed, such are the multitudes that a child can receive a diagnosis of bipolar in one State, but not in a neighbouring one. It was the force of this intra‐American division that swept over the Atlantic. As this has been the case for many other goods imported from the United States, the European high‐brow response was that pBD was just a New World fad. This response was evidently wrong. Of course, there are young children who have full‐blown manic and depressive episodes and who need treatment. And the bitter truth was (and continues to be in parts of the United Kingdom) that often such children are dismissed as having ‘character pathology’ and their families accused of all sorts of inadequacies. Clearly, here was an important problem hidden under layers of Old‐World crustiness.