Commentary: Frying pan to fire? Commentary on Stringaris et al. (2018)
Gabrielle A. Carlsona b✉, Daniel N. Kleinc d
- aDepartment of Psychiatry and Pediatrics Stony Brook University School of Medicine Stony Brook NY USA
- bDepartment of Psychiatry and Pediatrics, Stony Brook University School of Medicine, Stony Brook, NY, USA
- cDepartment of Psychology Stony Brook University Stony Brook NY USA
- dDepartment of Psychology, Stony Brook University, Stony Brook, NY, USA
- ✉Corresponding author
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Abstract
The bipolar disorder diagnosis in prepubertal children became popular because it answered a clinical need to treat the explosive behavior component of irritability and the hope that antimanic strategies would be helpful. Poor definition of episodes resulted in mixing chronic and episodic irritability in samples of children with bipolar disorder. The subsequent dramatic increase in neuroleptic use is a testimony to the importance of the problem of irritability and our need to better understand it. Insofar as our use of the term irritability conflates proneness to anger with the subsequent aggressive response, it will again not be clear who is being studied. We need to uncouple the mood and behavior aspects of irritability for further study or we will have traded the imprecision of "bipolar" for the imprecision of irritability.