Receiver Operating Characteristic Curve Analysis of Screening Tools for Bipolar Disorder Comorbid With ADHD in Schoolchildren

Cordeiro, Mara L.; Farias, Antônio Carlos de; Whybrow, Peter C.; Felden, Erico Pg; Cunha, Alexandre; Veiga, Vilmar da; Benko, Cássia R.; McCracken, James T.

doi:10.1177/1087054715620897

“…ROC analysis using data from four independent large data sets of children with and without a structured interview derived diagnosis of BP-I disorder showed that a combined t-score of 195 on the CBCL-BP profile efficiently identified children with pediatric BP-I disorder. These results support and extend previous results (9)(10)(11)(12)(13) and provide strong evidence that the CBCL-BP profile is a useful tool to help identify youth who may have BP-I disorder.…”

Section: Discussionsupporting

confidence: 89%

“…The CBCL is an empirically derived broadband assessment tool of psychopathology with excellent psychometric properties that has been translated into over 100 languages and is an easy to use paper and pencil instrument. A body of research (9)(10)(11)(12) and a meta-analysis (13) have shown very high correspondence between a unique profile of the CBCL consisting of elevations in the Attention, Anxiety/Depression and Aggression subscales greater than two standard deviations (SDs) above the norm (≥ 210 combined) with structured diagnostic interview derived clinical diagnosis of pediatric BP disorder (hence termed the CBCL-BP profile). However, because some studies failed to find an association between the CBCL-BP profile and a diagnosis of pediatric BP disorder, (14)(15)(16)(17)(18), there is a clear need for further evaluation of the utility of the CBCL to help identify children who may have BP disorder.…”

Section: Introductionmentioning

confidence: 99%

Further evidence of the Diagnostic Utility of the Child Behavior Checklist for identifying pediatric Bipolar I Disorder

Yule

¹

,

Fitzgerald

²

,

Wilens

³

et al. 2019

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: Pediatric bipolar (BP) disorder is a prevalent and highly morbid disorder. While structured diagnostic interviews have been developed to aid in the diagnosis of pediatric BP disorder, these tools are lengthy, costly and not widely available. One possible diagnostic aid is the Child Behavior Checklist (CBCL). Objective: To assess the diagnostic utility of the CBCL-BP profile to identify children with a diagnosis of BP-I disorder. Method: Subjects were derived from four independent data sets of children and adolescents with and without attention deficit hyperactivity disorder and BP-I. Subjects were recruited from pediatric and psychiatric clinics and the community. All subjects had structured clinical interviews with raters blinded to subject ascertainment status. We used an empirically derived profile from the CBCL consisting of an aggregate t-score from the Attention, Anxiety/Depression and Aggression subscales (CBCL-BP profile) to operationalize the presence or absence of BP symptoms. Receiver operating characteristic (ROC) curves were used to examine the ability of the CBCL-BP profile to identify children with and without a structured interview diagnosis of BP-I disorder. Results: The sample consisted of 661 subjects (mean age: 11.7 ± 3.3 years, 57% male and 94% Caucasian). In total, 20 percent of participants (n = 130) met structured interview criteria for a full diagnosis of BP-I disorder. The ROC analysis of the CBCL-BP profile yielded an area under the curve (AUC) of 0.91. A t-score of ≥ 195 on the CBCL-BP profile correctly classified 86% of subjects with BP-I disorder with 80% sensitivity, 87% specificity, 61% positive predictive value (PPV) and 95% negative predictive value (NPV). Conclusion: The CBCL-BP profile efficiently discriminated pediatric subjects with and without a structured interview diagnosis of BP-I disorder. Findings suggest that the CBCL-BP profile may be an efficient tool to help identify children who are very likely to suffer from BP-I disorder.

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“…Although our results demonstrating the very high efficiency of the CBCL-BP profile in identifying children with pediatric BP-I disorder are consistent with previous research in a sample of youth with and without ADHD and their siblings (10), in a sample of Brazilian children (12), and in a meta-analysis (13), data from two community samples of treatmentseeking youth did not find an association between the CBCL-BP profile with pediatric BP spectrum disorder (18,31). Although the reasons for these discrepancies are not entirely clear, several explanations are plausible.…”

Section: Discussionsupporting

confidence: 92%

“…The CBCL is an empirically derived broadband assessment tool of psychopathology with excellent psychometric properties that has been translated into over 100 languages and is an easy to use paper and pencil instrument. A body of research (9)(10)(11)(12) and a meta-analysis (13) have shown very high correspondence between a unique profile of the CBCL consisting of elevations in the Attention, Anxiety/Depression and Aggression subscales greater than two standard deviations (SDs) above the norm (≥ 210 combined) with structured diagnostic interview derived clinical diagnosis of pediatric BP disorder (hence termed the CBCL-BP profile). However, because some studies failed to find an association between the CBCL-BP profile and a diagnosis of pediatric BP disorder, (14)(15)(16)(17)(18), there is a clear need for further evaluation of the utility of the CBCL to help identify children who may have BP disorder.…”

Section: Introductionmentioning

confidence: 99%

3.11 Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder

Yule

¹

,

Fitzgerald²,

Wilens³

et al. 2018

Journal of the American Academy of Child & Adolescent Psych

1

0

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Background: Pediatric bipolar (BP) disorder is a prevalent and highly morbid disorder. While structured diagnostic interviews have been developed to aid in the diagnosis of pediatric BP disorder, these tools are lengthy, costly and not widely available. One possible diagnostic aid is the Child Behavior Checklist (CBCL). Objective: To assess the diagnostic utility of the CBCL-BP profile to identify children with a diagnosis of BP-I disorder. Method: Subjects were derived from four independent data sets of children and adolescents with and without attention deficit hyperactivity disorder and BP-I. Subjects were recruited from pediatric and psychiatric clinics and the community. All subjects had structured clinical interviews with raters blinded to subject ascertainment status. We used an empirically derived profile from the CBCL consisting of an aggregate t-score from the Attention, Anxiety/Depression and Aggression subscales (CBCL-BP profile) to operationalize the presence or absence of BP symptoms. Receiver operating characteristic (ROC) curves were used to examine the ability of the CBCL-BP profile to identify children with and without a structured interview diagnosis of BP-I disorder. Results: The sample consisted of 661 subjects (mean age: 11.7 ± 3.3 years, 57% male and 94% Caucasian). In total, 20 percent of participants (n = 130) met structured interview criteria for a full diagnosis of BP-I disorder. The ROC analysis of the CBCL-BP profile yielded an area under the curve (AUC) of 0.91. A t-score of ≥ 195 on the CBCL-BP profile correctly classified 86% of subjects with BP-I disorder with 80% sensitivity, 87% specificity, 61% positive predictive value (PPV) and 95% negative predictive value (NPV). Conclusion: The CBCL-BP profile efficiently discriminated pediatric subjects with and without a structured interview diagnosis of BP-I disorder. Findings suggest that the CBCL-BP profile may be an efficient tool to help identify children who are very likely to suffer from BP-I disorder.

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“…The scales constituting the ASEBA, developed by Achenbach and Rescorla (2001), have been used in several countries to track a wide range of mental health problems in childhood and adolescence (Dekker et al 2002;Cordeiro et al 2016;Raiker et al 2017). Assessment Data Manager is the ASEBA software that enables the analysis and comparison of data from multiple informants.…”

Section: Child Behaviour Checklist and Teacher's Report Formmentioning

confidence: 99%

Neuropsychological and behavioural profiles of students with intellectual development disorder on parents and teachers' perceptions

Furlin¹,

Bara²,

Felden

³

et al. 2021

J intellect Disabil Res

1

0

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Background Children with intellectual development disorder (IDD) have high rates of comorbid neuropsychological and behavioural problems. However, there are not many studies on this population in middle-income and low-income countries. Therefore, we aimed to investigate the prevalence of neuropsychological and behavioural problems in students with and without IDD and to assess the correlation between the responses from informants (parents and teachers) and the clinical diagnoses in Brazil. Methods After clinical diagnosis, 78 male and female students (7-15 years old) were divided into two groups: children with IDD (n = 39) and children without IDD (n = 39). The Child Behaviour Checklist (CBCL) and Teacher's Report Form (TRF) scales were used to track neuropsychological and behavioural problems. Calculations of prevalence ratios were performed using Poisson regression with Wald tests. The CBCL and TRF results were compared between groups with Mann-Whitney U-tests and receiver operating characteristic (ROC) analyses. The agreement between scales was assessed using the Spearman correlation test. Results Neuropsychological and behavioural problems were significantly more prevalent in students with IDD. The average amount of CBCL problems was significantly higher than that of TRF in the dimensions of thought, attention, somatic, attention deficit/hyperactivity, opposition defiant and total problems. Low-to-moderate correlations between CBCL and TRF dimensions in the IDD group were observed. ROC analyses revealed that the dimensions of internalising problems and total scores reflecting CBCL and TRF problems were the most important factors for identifying neuropsychological and behavioural problems in the IDD group. Conclusions Students with IDD require early identification of behavioural and emotional symptoms to avoid the underdiagnoses of various mental health problems, especially those with internalising characteristics. The CBCL and TRF may assist in the early screening of these comorbidities.

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Receiver Operating Characteristic Curve Analysis of Screening Tools for Bipolar Disorder Comorbid With ADHD in Schoolchildren

Abstract: The CBCL-PBD and P-YMRS can be used to screen for manic behavior and assist in differential diagnosis.

Cited by 6 publications

References 65 publications

Further evidence of the Diagnostic Utility of the Child Behavior Checklist for identifying pediatric Bipolar I Disorder

Further evidence of the Diagnostic Utility of the Child Behavior Checklist for identifying pediatric Bipolar I Disorder

3.11 Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder

Neuropsychological and behavioural profiles of students with intellectual development disorder on parents and teachers' perceptions

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