Pediatric Bipolar Disorder in an Era of "Mindless Psychiatry"

Peter Parry, Edmund Levin

    Research output: Contribution to journalReview articlepeer-review

    23 Citations (Scopus)


    Objective: Pediatric bipolar disorder (PBD) reflects shifts in conceptualizing bipolar disorder among children and adolescents since the mid-1990s. Since then, PBD diagnoses, predominantly in the United States, have increased dramatically, and the diagnosis has attracted significant controversy. During the same period, psychiatric theory and practice has become increasingly biological. The aim of this paper is to examine the rise of PBD in terms of wider systemic influences. Method: In the context of literature referring to paradigm shifts in psychiatry, we reviewed the psychiatric literature, media cases, and information made available by investigative committees and journalists. Results: Social historians and prominent psychiatrists describe a paradigm shift in psychiatry over recent decades: from an era of "brainless psychiatry," when an emphasis on psychodynamic and family factors predominated to the exclusion of biological factors, to a current era of "mindless psychiatry" that emphasizes neurobiological explanations for emotional and behavioral problems with limited regard for contextual meaning. Associated with this has been a tendency within psychiatry and society to neglect trauma and attachment insecurity as etiological factors; the "atheoretical" (but by default biomedical) premise of the Diagnostic and Statistical Manual of Mental Disorders (3rd and 4th eds.); the influence of the pharmaceutical industry in research, continuing medical education, and direct-to-consumer advertising; and inequality in the U.S. health system that favors "diagnostic upcoding." Harm from overmedicating children is now a cause of public concern. Conclusion: It can be argued that PBD as a widespread diagnosis, particularly in the United States, reflects multiple factors associated with a paradigm shift within psychiatry rather than recognition of a previously overlooked common disorder.

    Original languageEnglish
    Pages (from-to)51-68
    Number of pages18
    JournalJournal of Trauma and Dissociation
    Issue number1
    Publication statusPublished - Jan 2012


    • affective disorders
    • attachment
    • behavioral disorders
    • behavioral medicine
    • childhood trauma
    • diagnostic validity
    • DSM validity
    • emotion regulation
    • pediatric illness
    • professional attitudes


    Dive into the research topics of 'Pediatric Bipolar Disorder in an Era of "Mindless Psychiatry"'. Together they form a unique fingerprint.

    Cite this