Objective: Whilst a substantial body of literature has accumulated on pediatric bipolar disorder (PBD) over recent years, it remains a contentious diagnosis. Critics have suggested that attachment and trauma related factors are overlooked and that PBD research would benefit from a developmental psychopathology perspective. Conversely authors of the PBD literature often argue that child and adolescent psychiatrists and allied child mental health practitioners have traditionally overlooked or misdiagnosed PBD as other childhood disorders. This literature sought to examine these claims.
Methods: A body of PBD literature was searched using Scopus (academic search engine) and in order to achieve specificity to PBD was refined to 1,365 post-1995 publications from the top 70 authors. These were then searched in all fields for terms relating to attachment, trauma and maltreatment. A body of attachment and developmental trauma literature was also defined by Scopus search to 721 publications from the top 70 authors in this area; these were then searched for PBD terms.
Results: Of 1,365 PBD articles only 15 included the word "attachment" and only 3 applied it in the context of attachment theory as a significant theme in the text. Maltreatment/abuse and trauma/PTSD aspects were infrequently considered. Trauma/PTSD was seen as secondary to PBD by researchers affiliated with one of the main PBD research institutions. Of 721 attachment and developmental trauma related articles only 3 mentioned PBD.
Conclusions: A search of the PBD literature for terms like "attachment", "PTSD", "maltreatment" and "abuse" with the Scopus search engine, lends credence to critic claims that the PBD literature in general neglects or dismisses attachment theory. Furthermore trauma concepts are generally not related to attachment perspectives. Conversely a more cursory search of attachment theory and traumatology based literature suggests neglect or dismissal of the concept of PBD. There thus appears to be a large communication gulf between two different paradigmatic approaches in child & adolescent psychiatry and developmental psychopathology. Resolution of the controversy surrounding PBD may benefit from increased dialogue across these two paradigms.