Patricia Wen of the Boston Globe posted an article today entitled “Psychiatrist admits she approved higher drug dosage in Riley trial. In it, she recounts the testimony given today by Dr. Kayoko Kifuji, the psychiatrist who had diagnosed and treated Rebecca Riley for bipolar disorder and attention deficit hyperactivity disorder (ADHD). I read the article cautiously, because there are so many facets to consider in watching this trial unfold, but the psychiatric testimony carries a lot of weight.

Dr. Kifuji testified that she had diagnosed Rebecca’s older sister with bipolar disorder at two years of age. While I would not diagnose bipolar disorder in a two year old, there are many in my field who feel that it is possible to make such a diagnosis and that, in fact, it is extremely important to diagnose as early as possible to give the best treatment possible.

In my work with very young children, parents often ask me whether the child has bipolar disorder. Typically the child is exhibiting hyperactive and impulsive behaviors with aggressive outbursts and sometimes sleep problems. The parents have read somewhere that these are symptoms of bipolar disorder.

I spend a lot of time with families reviewing the specific criteria for bipolar disorder – specifically needing something that looks a little bit like a manic episode – and most often we don’t find it. Working together, we may find anxiety, ADHD, depression, language or learning problems, autistic spectrum features, and many times difficult or chaotic family settings along with any number of stresses and challenges and a wide range of parenting responses that may exacerbate these behaviors rather than reduce them. Treatment for these situations usually requires many non- medical interventions before I pull out the prescription pad.

This testimony just amplifies the difficulties there are in working with children and families that are dealing with severe emotional and behavioral symptoms in a child. Diagnoses are extremely difficult and treatment even more so.

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From Psych Central's website:
PsychCentral (January 25, 2010)

Twitter Trackbacks for Dr. Kayoko Kifuji testifies in Rebecca Riley Murder Trial | Bipolar Beat [psychcentral.com] on Topsy.com (January 26, 2010)

    Last reviewed: 25 Jan 2010