The number of American children and adolescents diagnosed with BD in community hospitals increased 40-fold, changing from almost never being diagnosed to reaching rates of up to 40% in some hospital settings in 10 years around the beginning of the current[vague] century,[unreliable medical source?][13][14] while in outpatient clinics it doubled reaching the 6%.[3] Outpatient office visits for children and adolescents with bipolar disorder in the United States increased from 20,000 in 1994–95 to 800,000 in 2002–03.[15] The data suggest that doctors had been more aggressively applying the diagnosis to children, rather than that the incidence of the disorder has increased.[16]