What Killed Rebecca Riley?

Katie Couric Reports On The Diagnosis Of Bipolar Disorder In Kids

On Dec. 13, 2006, police responded to a 911 call and found a little girl lying dead on the floor next to her parents' bed. The autopsy revealed that she had died from an overdose of psychiatric drugs. Rebecca Riley was being treated for bipolar disorder, or manic depression, even though she was just four years old.

If that sounds unusual to you, it's not. As Katie Couric reports, until recently the disorder was believed to emerge only in adults. Now, it is estimated that there are nearly one million children diagnosed as bipolar, making it more common than autism and diabetes combined. And to treat it, doctors are administering some medications that have yet to be approved for children. In the case of Rebecca Riley, that cocktail of medications proved fatal and now her parents have been charged with her murder.

Carolyn Riley is now in jail in Boston awaiting trial and is being medicated for depression. She told 60 Minutes her daughter's problems began when Rebecca was only two years old. Carolyn took her to a psychiatrist because she had difficulty sleeping and seemed hyperactive.

"Constantly getting into things, running around, not being able to settle down," Riley remembers.

"Did you ever think, 'Well, she's two and a half years old.' There's this thing called the terrible 2's. Did you think this could, in fact, be normal?" Couric asks.

"Yes," Riley tells Couric. "The psychiatrist said that she thought that it was more than just normal."

The toddler who could barely speak in full sentences was diagnosed with bipolar disorder after several sessions over eight months. She had just turned 3. And she wasn't the only one in the family: her ten-year-old brother and four-year-old sister were already being treated for the same illness by the same doctor at Tufts-New England Medical Center. Rebecca was eventually prescribed three medications to stabilize her mood: Seroquel, an anti psychotic; Depakote, an anti seizure drug; and Clonidine, a blood pressure medication -- medications that would ultimately prove fatal on Dec. 13th.

Riley says she thought Rebecca had just a little bit of a cold and gave her daughter "Children's Tylenol Plus Cough & Runny Nose."

In the middle of the night, Riley remembers her daughter didn't want to go to sleep. "So I brought her in the room. She was right beside me on the floor. And I laid down and went to sleep," she recalls.

Before she put her to bed that night, next to her on the floor, Riley says she gave her daughter half a Clonidine.

Asked why, Riley tells Couric, "Because she hadn't been able to get to sleep since six o'clock."

"Then what happened?" Couric asks.

"Then I woke up to the alarm in the morning. And knelt down to wake her up. And there was no waking her up," Riley replies.

Riley says she knew at that point that her daughter had died. Carolyn Riley and her husband Michael were charged with first-degree murder.

The prosecutor alleged at their arraignment in February that they were overdosing Rebecca by repeatedly giving her more medication than she was prescribed. "It was used on Rebecca, her sister and her brother for one simple purpose by these defendants: to knock them out and make them sleep," the prosecutor claimed.

But the Rileys claim that they were following doctor's orders. 60 Minutes wanted to talk to the psychiatrist, Dr. Kayoko Kifuji, but she declined. Instead 60 Minutes got a statement from her hospital: "The care we provided was appropriate and within responsible professional standards."

60 Minutes did obtain a copy of Rebecca's medical records. In them, Dr. Kifuji notes Rebecca's increased risk of mental illness because of her family history. She diagnosed Rebecca after Carolyn said her daughter was - quote - "driving me crazy" and her mood switches within a minute. She would eventually prescribe the preschooler more than ten pills a day.

Riley says she did feel that that was a lot of pills for a little girl, but she says she went ahead and gave Rebecca the prescriptions. "I trusted the doctor," she says.

Dr. Kifuji has stopped practicing, pending a ruling by the state medical board. But her lawyer has said she was just practicing mainstream psychiatry. It's now estimated that nearly one million children like Rebecca Riley have been diagnosed with bipolar disorder, or manic depression. And while some psychiatrists told 60 Minutes that early diagnosis is saving lives, a growing number of doctors say it is being over-diagnosed.