Affiliations: North Wales Department of Psychological Medicine, Cardiff University, Bangor LL57 2PW, Wales, UK
Note: [] Address for correspondence: David Healy, North Wales Department of Psychological Medicine, Cardiff University, Bangor LL57 2PW, Wales, UK. Fax: +44 1248 371397; E-mail: healy_hergest@compuserve.com
Abstract: In the past decade bipolar disorder in children has been diagnosed with rapidly increasing frequency in North America, despite a century of psychiatric consensus that manic-depressive illness rarely had its onset before adolescence. This emergence has happened against a background of vigorous pharmaceutical company marketing of bipolar disorder in adults. In the absence of a license demonstrating efficacy for their compound for bipolar disorder in children, however, companies cannot actively market pediatric bipolar disorder. This paper explores some mechanisms that play a part in spreading the recognition of a disorder in populations for which pharmaceutical companies do not have a license. These include the role of academic experts, parent pressure groups, measurement technologies and the availability of possible remedies even if not licensed.
