Bipolar spectrum disorders (BPSD) are commonly misdiagnosed in community mental health settings, resulting in suboptimal treatment selection that can actually worsen the course of the disorder. Part of the difficulty in diagnosis is the current lack of consensus about the phenomenology of juvenile BPSD. At present, there also is no certainty about the base rate at which BPSD might present at a community mental health setting, nor is there an established set of instruments that could be used to screen a juvenile community sample for bipolar spectrum disorders. Such a screening protocol is sorely needed, given the long-term trajectory and serious consequences of untreated or mistreated BPSD, and the potential value of early intervention if juvenile cases could be identified. Preliminary evidence from this research group suggests that several measures perform well at distinguishing BPSD from unipolar depression, disruptive behavior disorders, and other disorders in children and adolescents (see Appendices). However, these findings were based on a sample presenting at an outpatient research clinic specializing in the treatment of juvenile mood disorders and psychopharmacology research. Thus, several factors prevent the immediate application of existing findings to a community setting, including the lack of soundly-established base rate of BPSD at community- based mental health centers, the unknown effects of potential ascertainment bias at a mood disorders clinic versus a community setting, changes in demographics or other sample characteristics that might interact with test performance, and the fact that test performance might degrade when exported from a research framework into a community context - much as therapeutic efficacy estimates usually exceed effectiveness findings. The purpose of the proposed study is to develop effective means of screening for bipolar spectrum disorders in a community mental health setting serving an ethnically and racially diverse population. This will be accomplished by determining the prevalence of bipolar disorders in a community sample, validating measures that have performed well in an academic clinical setting, and clarifying the features of early presentation of bipolar spectrum disorders along with their longitudinal course over 18 months. Particular attention is paid to identifying and validating diagnostic characteristics of youths with bipolar symptoms that do not meet full criteria for a bipolar diagnosis. These children, currently labeled """"""""Bipolar- Not Otherwise Specified"""""""", may represent an early developmental precursor of later bipolar disorder, or they may manifest a developmentally different presentation and course.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH066647-04
Application #
7127286
Study Section
Biobehavioral and Behavioral Processes 3 (BBBP)
Program Officer
Avenevoli, Shelli A
Project Start
2003-06-01
Project End
2006-06-30
Budget Start
2006-04-01
Budget End
2006-06-30
Support Year
4
Fiscal Year
2006
Total Cost
$206,027
Indirect Cost
Name
Case Western Reserve University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Van Meter, Anna R; Algorta, Guillermo Perez; Youngstrom, Eric A et al. (2018) Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment. Eur Child Adolesc Psychiatry 27:159-169
Youngstrom, Eric A; Halverson, Tate F; Youngstrom, Jennifer K et al. (2018) Evidence-Based Assessment from Simple Clinical Judgments to Statistical Learning: Evaluating a Range of Options Using Pediatric Bipolar Disorder as a Diagnostic Challenge. Clin Psychol Sci 6:243-265
Salcedo, Stephanie; Rizvi, Sabeen H; Freeman, Lindsey K et al. (2018) Diagnostic efficiency of the CBCL thought problems and DSM-oriented psychotic symptoms scales for pediatric psychotic symptoms. Eur Child Adolesc Psychiatry 27:1491-1498
Gruber, June; Van Meter, Anna; Gilbert, Kirsten E et al. (2017) Positive Emotion Specificity and Mood Symptoms in an Adolescent Outpatient Sample. Cognit Ther Res 41:393-405
You, Dokyoung S; Youngstrom, Eric A; Feeny, Norah C et al. (2017) Comparing the Diagnostic Accuracy of Five Instruments for Detecting Posttraumatic Stress Disorder in Youth. J Clin Child Adolesc Psychol 46:511-522
Raiker, Joseph S; Freeman, Andrew J; Perez-Algorta, Guillermo et al. (2017) Accuracy of Achenbach Scales in the Screening of Attention-Deficit/Hyperactivity Disorder in a Community Mental Health Clinic. J Am Acad Child Adolesc Psychiatry 56:401-409
Du Rocher Schudlich, Tina; Youngstrom, Eric A; Martinez, Maria et al. (2015) Physical and sexual abuse and early-onset bipolar disorder in youths receiving outpatient services: frequent, but not specific. J Abnorm Child Psychol 43:453-63
Jensen-Doss, Amanda; Youngstrom, Eric A; Youngstrom, Jennifer Kogos et al. (2014) Predictors and moderators of agreement between clinical and research diagnoses for children and adolescents. J Consult Clin Psychol 82:1151-62
Van Meter, Anna; Youngstrom, Eric; Youngstrom, Jennifer Kogos et al. (2014) Clinical decision making about child and adolescent anxiety disorders using the Achenbach system of empirically based assessment. J Clin Child Adolesc Psychol 43:552-65
Youngstrom, Eric A (2014) A primer on receiver operating characteristic analysis and diagnostic efficiency statistics for pediatric psychology: we are ready to ROC. J Pediatr Psychol 39:204-21

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