Award Date

May 2019

Degree Type


Degree Name

Master of Arts (MA)



First Committee Member

Andrew Freeman

Second Committee Member

Kristen Culbert

Third Committee Member

Rachael Robnett

Fourth Committee Member

Jennifer Keene

Number of Pages



The rate of PBD in the U.S. increased dramatically between the mid-1990s and mid-2000s resulting in concern regarding the potential for misdiagnosis of PBD. However, given that the rate of PBD diagnosis had not been examined in the U.S. since 2004, the longitudinal trajectory of PBD diagnosis subsequent to the mid-2000s was unclear. Therefore, the present study utilized two datasets of administrative billing claims to assess whether longitudinal changes in the rate of inpatient PBD diagnosis continued to occur subsequent to 2004. Study 1 utilized a nationally representative dataset of inpatient psychiatric hospitalizations between 1996 and 2010. De-identified data were obtained from the National Hospital Discharge Survey (NHDS) conducted annually by the National Center for Health Statistics. Study 2 utilized a state-level database of de-identified Medicaid billing claims between 2005 and 2015. Data included youth ages five to 17 hospitalized at one of five psychiatric inpatient hospitals in Nevada during the study period. Results indicated that the proportion of PBD diagnoses to all psychiatric diagnoses increased between 1996 and 2004 among children and adolescents. The proportion of PBD diagnoses then decreased between 2004 and 2010 among children but continued to increase for adolescents. However, the population-adjusted rates of PBD diagnosis per 10,000 individuals in the general population initially increased until the mid-2000s and then decreased until 2010 for all age groups. State-level data indicated a decline in the rate of PBD diagnosis between 2005 and 2015. Findings provide insight into changing trends in inpatient service utilization for BD in the U.S. Awareness of the current diagnostic trends for BD may assist inpatient administrators and clinicians in preparing for anticipated service utilization and planning allocation of resources. Further research is necessary to evaluate continuously changing diagnostic rates and to determine the exact causes of changing trends in diagnosis across time.



File Format


Degree Grantor

University of Nevada, Las Vegas




IN COPYRIGHT. For more information about this rights statement, please visit

Included in

Psychology Commons