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Citation
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Uchida M, Faraone SV, Martelon M, Kenworthy T, Woodworth KY, Spencer TJ, Wozniak JR, Biederman J. J. Affect. Disord. 2014; 165: 81-86. |
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Affiliation
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Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: jbiederman@partners.org. |
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Abstract
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BACKGROUND: Previous work shows that children with high scores (2SD, combined score≥210) on the Attention Problems, Aggressive Behavior, and Anxious-Depressed (A-A-A) subscales of the Child Behavior Checklist (CBCL) are more likely than other children to meet criteria for bipolar (BP)-I disorder. However, the utility of this profile as a screening tool has remained unclear.
METHODS: We compared 140 patients with pediatric BP-I disorder, 83 with attention deficit hyperactivity disorder (ADHD), and 114 control subjects. We defined the CBCL-Severe Dysregulation profile as an aggregate cutoff score of≥210 on the A-A-A scales. Patients were assessed with structured diagnostic interviews and functional measures.
RESULTS: Patients with BP-I disorder were significantly more likely than both control subjects (Odds Ratio [OR]: 173.2; 95% Confidence Interval [CI], 21.2 to 1413.8; P<0.001) and those with ADHD (OR: 14.6; 95% CI, 6.2 to 34.3; P<0.001) to have a positive CBCL-Severe Dysregulation profile. Receiver Operating Characteristics analyses showed that the area under the curve for this profile comparing children with BP-I disorder against control subjects and those with ADHD was 99% and 85%, respectively. The corresponding positive predictive values for this profile were 99% and 92% with false positive rates of<0.2% and 8% for the comparisons with control subjects and patients with ADHD, respectively. LIMITATIONS: Non-clinician raters administered structured diagnostic interviews, and the sample was referred and largely Caucasian.
CONCLUSIONS: The CBCL-Severe Dysregulation profile can be useful as a screen for BP-I disorder in children in clinical practice.
Language: en |