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Alcaíno C, Raouna A, Tunç H, MacBeth A, Bird T, Youngstrom E. Discriminant diagnostic validity of paediatric bipolar disorder screening tests: A systematic review and meta-analysis. Early Interv Psychiatry 2024. [PMID: 39103165 DOI: 10.1111/eip.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/24/2024] [Accepted: 06/30/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Bipolar disorders (BD) are among the most significantly impairing of childhood and adolescent psychiatric disorders. Although BD symptoms may begin in adolescence, they are frequently not diagnosed until adulthood, and accordingly BD scales could aid diagnostic assessment in paediatric populations. This review aims to synthesis the evidence for the accuracy of BD symptom index tests for discriminating BD from non-BD (other diagnoses or healthy controls) in paediatric population. Additionally, several theoretically relevant moderators of diagnostic accuracy were evaluated. METHODS A systematic search across three databases were conducted from 1980 to 2022, augmented by grey literature database searches, citation chaining and contacting authors. Data from eligible studies were synthesized using meta-analysis. A multilevel model was fitted to account for nested effect sizes, with 31 potential moderators examined in univariate and multivariate models. RESULTS Twenty-Eight studies were eligible, yielding 115 effect sizes for analysis. Meta-analytic modelling indicated BD symptom index tests have a high diagnostic accuracy (g = 1.300; 95% CI: 0.982 - 1.619; p < .001) in paediatric population. Accuracy was relative to the type of comparison group, index test content, index test informant and index test's scale or subscale. CONCLUSIONS Screening tests based on mania content, caregiver report and non-healthy comparison groups have clinical utility in identifying paediatric BD. Other informant-and-content combination may not accurately identify paediatric BD. Unlike healthy controls, tests derived from studies using non-healthy comparison groups, represent BD symptom non-specificity and BD symptom overlap with other disorders, providing external validity and clinical utility.
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Affiliation(s)
- Cristian Alcaíno
- School of Health in Social Science, University of Edinburgh, Scotland, UK
| | - Aigli Raouna
- School of Health in Social Science, University of Edinburgh, Scotland, UK
| | - Hamdullah Tunç
- School of Health in Social Science, University of Edinburgh, Scotland, UK
- Hacettepe Üniversitesi, Ankara, Turkey
| | - Angus MacBeth
- School of Health in Social Science, University of Edinburgh, Scotland, UK
| | - Timothy Bird
- School of Health in Social Science, University of Edinburgh, Scotland, UK
| | - Eric Youngstrom
- The Ohio State University, Columbus, Ohio, USA
- Nationwide Children's Hospital, Columbus, Ohio, USA
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Eraso-Osorio JJ, Palacio-Ortiz JD, Quintero-Cadavid CP, Estrada-Jaramillo S, Andrade-Carrillo R, Gómez-Cano S, Garcia-Valencia J, Aguirre-Acevedo DC, Duque-Rios PA, Valencia-Echeverry J, López-Jaramillo C. High risk for psychiatric disorders in bipolar offspring. A four years prospective study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 50:273-284. [PMID: 34815013 DOI: 10.1016/j.rcpeng.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/30/2020] [Indexed: 06/13/2023]
Abstract
UNLABELLED Bipolar disorder (BD) has a large hereditary component. It is a disorder that begins in early adulthood, but about which it has been described a premorbid period preceding the onset of BD. During this herald expression psychiatric disorders and symptoms, such as depressive, manic, psychotic, anxious and others, may appear. OBJECTIVE To determine the psychopathological profile of a Bipolar Offspring (BO) group compared with the Community Control Offspring (CCO) group, and its evolution over time, including subthreshold symptoms and mental disorders. METHODS We conducted an observational mixed cohort study, with a prospective design. We included subjects from six to 30 years of age, from the region of Antioquia, Colombia. A total of 131 subjects from the risk group BO and 150 subjects from the CCO group were evaluated through validated psychiatric diagnostic interviews (K-SADS-PL and DIGS) at baseline and at 4 years follow up. All interviews were carried out by a staff blind to parent diagnoses. Follow-up assessment were complete in 72% of the offspring. Forty-two subjects were excluded as they surpassed the age of 30 years, and only 46 subjects were not followed (change of address or did not consent to participate). RESULTS Compared with the CCO group, the BO group had a higher frequency of affective disorder, psychotic disorder, externalizing disorders and use of the psychoactive substances during both assessments at time 1 and 2. The magnitude of the differences between the groups increased when they reach time 2. The BO group had a greater risk for presenting subthreshold symptoms and definitive psychiatric disorders, such as affective disorders, psychotic disorders and externalizing disorders. In addition, the BO group had a younger age of onset for psychoactive substances consumption. CONCLUSION During the follow-up period, the BO group had a higher risk of presenting mental disorders compared with the CCO group. The most relevant symptoms and disorders that could precede the onset of BD were depressive, bipolar not otherwise specified, psychotic and substance use.
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Affiliation(s)
- Juan Jose Eraso-Osorio
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia.
| | - Claudia Patricia Quintero-Cadavid
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Santiago Estrada-Jaramillo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Rommel Andrade-Carrillo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Sujey Gómez-Cano
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | | | - Daniel Camilo Aguirre-Acevedo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Institute of Medical Research, University of Antioquia, Medellín, Colombia
| | - Paula Andrea Duque-Rios
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Johanna Valencia-Echeverry
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Carlos López-Jaramillo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
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Muratori F, Santocchi E, Calderoni S. Psychiatric assessment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:217-238. [PMID: 32977880 DOI: 10.1016/b978-0-444-64148-9.00016-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies have consistently reported an increased prevalence of psychiatric comorbidity (PC) in individuals with neurodevelopmental disorders (NDDs) compared with typically developing controls, with high rates of anxiety disorders in autism spectrum disorders and challenging behaviors in children and adolescent with intellectual disability. Psychiatric assessment in this population should include multiple sources of information, derived from multiple contexts and using multiple methods, with accurate detection of contributing and trigger factors. It is important to focus on detecting change from the child's baseline functioning and to use, when possible, ad hoc instruments for assessing PC in the NDD population. Modifications in the setting and assessment procedures should be scheduled based on the child's age, developmental level, and sensory sensitivities. Simultaneously, validated screening instruments, which dimensionally assess the symptomatology of several NDDs and psychiatric disorders, are warranted to not only assist in the identification of PCs in NDDs but also discriminate among different NDDs. Changes from DSM-IV-TR to DSM-5 have had an impact on the diagnosis of several disorders in children and adolescents and, subsequently, on the current diagnostic tools, requiring appropriate and prompt modifications of the available instruments.
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Affiliation(s)
- Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Santocchi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Eraso-Osorio JJ, Palacio-Ortiz JD, Quintero-Cadavid CP, Estrada-Jaramillo S, Andrade-Carrillo R, Gómez-Cano S, Garcia-Valencia J, Aguirre-Acevedo DC, Duque-Rios PA, Valencia-Echeverry J, López-Jaramillo C. High Risk for Psychiatric Disorders in Bipolar Offspring. A Four Years Prospective Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 50:S0034-7450(20)30048-2. [PMID: 33735023 DOI: 10.1016/j.rcp.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/16/2019] [Accepted: 01/30/2020] [Indexed: 10/24/2022]
Abstract
Bipolar disorder (BD) has a large hereditary component. It is a disorder that begins in early adulthood, but about which it has been described a premorbid period preceding the onset of BD. During this herald expression psychiatric disorders and symptoms, such as depressive, manic, psychotic, anxious and others, may appear. OBJECTIVE To determine the psychopathological profile of a Bipolar Offspring (BO) group compared with the Community Control Offspring (CCO) group, and its evolution over time, including subthreshold symptoms and mental disorders. METHODS We conducted an observational mixed cohort study, with a prospective design. We included subjects from six to 30 years of age, from the region of Antioquia, Colombia. A total of 131 subjects from the risk group BO and 150 subjects from the CCO group were evaluated through validated psychiatric diagnostic interviews (K-SADS-PL and DIGS) at baseline and at 4 years follow up. All interviews were carried out by a staff blind to parent diagnoses. Follow-up assessment were complete in 72% of the offspring. Forty-two subjects were excluded as they surpassed the age of 30 years, and only 46 subjects were not followed (change of address or did not consent to participate). RESULTS Compared with the CCO group, the BO group had a higher frequency of affective disorder, psychotic disorder, externalizing disorders and use of the psychoactive substances during both assessments at time 1 and 2. The magnitude of the differences between the groups increased when they reach time 2. The BO group had a greater risk for presenting subthreshold symptoms and definitive psychiatric disorders, such as affective disorders, psychotic disorders and externalizing disorders. In addition, the BO group had a younger age of onset for psychoactive substances consumption. CONCLUSION During the follow-up period, the BO group had a higher risk of presenting mental disorders compared with the CCO group. The most relevant symptoms and disorders that could precede the onset of BD were depressive, bipolar not otherwise specified, psychotic and substance use.
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Affiliation(s)
- Juan Jose Eraso-Osorio
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia.
| | - Claudia Patricia Quintero-Cadavid
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Santiago Estrada-Jaramillo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Rommel Andrade-Carrillo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Sujey Gómez-Cano
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | | | - Daniel Camilo Aguirre-Acevedo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Institute of Medical Research, University of Antioquia, Medellín, Colombia
| | - Paula Andrea Duque-Rios
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
| | - Johanna Valencia-Echeverry
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Carlos López-Jaramillo
- Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia
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Youngstrom EA, Perez Algorta G, Youngstrom JK, Frazier TW, Findling RL. Evaluating and Validating GBI Mania and Depression Short Forms for Self-Report of Mood Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:579-595. [PMID: 32401546 DOI: 10.1080/15374416.2020.1756301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: To evaluate short forms of free self-report mania and depression scales, evaluating their reliability, content coverage, criterion validity, and diagnostic accuracy.Method: Youths age 11 to 18 years seeking outpatient mental health services at either an Academic medical clinic (N = 427) or urban Community mental health center (N = 313), completed the General Behavior Inventory (GBI) and other rating scales. Youths and caregivers completed semi-structured interviews to establish diagnoses and mood symptom severity, with GBI scores masked during diagnosis. Ten- and seven-item short forms, psychometric projections, and observed performance were tested first in the Academic sample and then externally cross-validated in the Community sample.Results: All short forms maintained high reliability (all alphas >.80 across both samples), high correlations with the full-length scales (r.85 to.96), excellent convergent and discriminant validity with mood, behavior, and demographic criteria, and diagnostic accuracy undiminished compared to using the full-length scales. Ten-item scales showed advantages in terms of coverage; the 7 Up showed slightly weaker performance.Conclusions: Present analyses evaluated and externally cross-validated short forms that maintain high reliability and content coverage, and show strong criterion validity and diagnostic accuracy - even when used in an independent sample with very different demographics and referral patterns. The short forms appear useful in clinical applications including initial evaluation, as well as in research settings where they offer an inexpensive quantitative score. Short forms are available in more than two dozen languages. Future work should further evaluate sensitivity to treatment effects and cultural invariance.
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Affiliation(s)
- Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights
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Youngstrom EA, Van Meter A, Frazier TW, Youngstrom JK, Findling RL. Developing and Validating Short Forms of the Parent General Behavior Inventory Mania and Depression Scales for Rating Youth Mood Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 49:162-177. [DOI: 10.1080/15374416.2018.1491006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Anna Van Meter
- Department of Psychiatry Research, Zucker Hillside Hospital
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Youngstrom EA, Van Meter A. Empirically Supported Assessment of Children and Adolescents. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12172] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Eric A. Youngstrom
- Department of Psychology and Neuroscience; University of North Carolina at Chapel Hill
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Pendergast LL, Youngstrom EA, Brown C, Jensen D, Abramson LY, Alloy LB. Structural invariance of General Behavior Inventory (GBI) scores in Black and White young adults. Psychol Assess 2015; 27:21-30. [PMID: 25222430 PMCID: PMC4355320 DOI: 10.1037/pas0000020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the United States, Black and White individuals show discrepant rates of diagnosis of bipolar disorder versus schizophrenia and antisocial personality disorder, as well as disparate access to and utilization of treatment for these disorders (e.g., Alegria, Chatterji, et al., 2008; Chrishon, Anderson, Arora, & Bailey, 2012). Such diagnostic discrepancies might stem from racially related cognitive biases in clinical judgment or from racial biases in measurements of bipolar disorder. The General Behavior Inventory (GBI) is among the most well-validated and widely used measures of bipolar mood symptoms, but the psychometric properties of the GBI have been examined primarily in predominantly White samples. In this study, we used multigroup confirmatory factor analyses (CFA) to examine the invariance of GBI scores across racial groups with a nonclinical sample. Fit was acceptable for tests of configural invariance, equal factor loadings, and equal intercepts, but not invariance of residuals. Findings indicate that GBI scores provide functionally invariant measurement of mood symptoms in both Black and White samples. The use of GBI scores may contribute consistent information to clinical assessments and could potentially reduce diagnostic discrepancies and associated differences in access to and utilization of mental health services.
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Affiliation(s)
- Laura L Pendergast
- Department of Psychological, Organizational, and Leadership Studies in Education
| | - Eric A Youngstrom
- Department of Psychological, Organizational, and Leadership Studies in Education, Temple University
| | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison
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