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.