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Background: The paediatric bipolar disorder (PBD) hypothesis arose in the USA and proposes childhood onset and high rates of prevalence. Method: Child and adolescent psychiatrists in Australia and New Zealand were surveyed about the PBD hypothesis. Results: Sixty percent responded ( N = 199) and most (53%) reported never having diagnosed pre-pubertal PBD and a further 29% estimated seeing ‘1 or 2’ cases. Most (83%) rated pre-pubertal PBD as ‘very rare’, ‘rare’ or ‘not diagnosable’. Opinion varied as to whether PBD was over-diagnosed (25%), appropriately diagnosed (42%), or under-diagnosed (28%) in Australia and New Zealand, 5% were unsure. In contrast there was a consensus of views that PBD was over-diagnosed in the USA (90%), whilst less felt it appropriately diagnosed (3%), or under-diagnosed (1%) and 6% were unsure. Conclusions: The majority view was consistent with classical descriptions of bipolar disorder. [ABSTRACT FROM AUTHOR]