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

	Boys ADHD study		Girls ADHD study		BP disorder controlled study		BP disorder family study		All studies combined
	No BP disorder	BP disorder	No BP disorder	BP disorder	No BP disorder	BP disorder	No BP disorder	BP disorder	No BP disorder	BP disorder
	n = 238	n = 13	n = 211	n = 9	n = 82	n = 64	n = n/a	n = 44	n = 531	n = 130	Test statistic	p-value
	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD
Age	11.1 ± 3.3	10.3 ± 3.3	11.7 ± 3.2	11.0 ± 3.3	13.5 ± 2.1	13.7 ± 2.4	n/a	9.2 ± 3.4	11.7 ± 3.2	11.7 ± 3.6	t₆₅₉ = 0.08	0.94
Socioeconomic status^a	1.7 ± 0.9	2.1 ± 1.0	1.8 ± 0.9	1.8 ± 0.7	1.6 ± 1.0	1.9 ± 1.2	n/a	1.8 ± 1.0	1.7 ± 0.9	1.8 ± 1.1	z = -1.29	0.20

	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Male	238 (100)	13 (100)	0 (0)	0 (0)	48 (59)	43 (67)	n/a	34 (77)	286 (54)	90 (69)	χ² = 10.06	0.002
Caucasian^b	238 (100)	13 (100)	192 (93)	9 (100)	58 (76)	62 (98)^*	n/a	38 (86)	488 (94)	122 (95)	χ² = 0.10	0.76

1 Note. ADHD = attention deficit hyperactivity disorder; BP = Bipolar

2a Socioeconomic status (SES) was measured using the 5-point Hollingshead scale. A higher score indicates being of lower SES. Not everyone has SES reported. Smaler sample sizes for this measure were: boys ADHD study: 251; girls ADHD study: 219: BP controlled study: 108; all studies combined: 622.

3b Not everyone has race reported. Smaller sample sizes for this measure were: girls ADHD study: 215, BP disorder controlled study: 139; all studies combined: 649.

4* Significant difference in percent Caucasian between those with and without bipolar disorder in the BP-I disorder controlled study, p < 0.001

TABLE 2.

Sensitivity, specificity and percent correctly classified using the Child Behavior Checklist-Bipolar (BP) profile with ≥ 180 to identify youth with BP-I disorder in each study

Study	Sensitivity (%)	Specificity (%)	Correctly classified (%)
Boys ADHD study (n = 251)	85	74	74
Girls ADHD study (n = 220)	89	74	75
BP disorder controlled study (n = 146)	89	93	91
BP disorder family study (n = 44)	91	n/a^a	91

1 Note. ADHD = attention deficit hyperactivity disorder

2a Specificity could only be calculated for studies that included control subjects

Receiver operating characteristic (ROC) curve of the Child Behavior Checklist-Bipolar Profile T-scores in subjects from the total sample with and without Bipolar I disorder (n = 661)

TABLE 3.

Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and percent correctly classified in the use of the Child Behavior Checklist-Bipolar (BP) profile t-scores to identify youth with BP-I disorder in the total sample from all four studies (n = 661)

CBCL-BP profile Cut-point	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Correctly classified (%)
≥ 165	95	63	39	98	69
≥ 180	89	77	49	97	79
≥ 195^*	80	87	61	95	86
≥ 210	61	94	72	91	88
≥ 225	39	97	79	87	86
≥ 240	15	99	86	83	83

1* A cut-point of 195 for the CBCL-BP profile had the best properties to correctly identify subjects with a diagnosis of BP-I disorder as determined by the AUC

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DOI: https://doi.org/10.21307/sjcapp-2019-006 | Journal eISSN: 2245-8875

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Language: English

Page range: 1 - 8

Published online: Jun 6, 2019

Published in print: Jan 1, 2019

Published by: Center for Evidence-based Psychiatry

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Bipolar disorder,

behavior,

child and adolescent psychiatry

Related subjects:

Medicine,

Basic medical science,

Basic medical science, other

© 2019 Amy Yule, Maura Fitzgerald, Timothy Wilens, Janet Wozniak, K. Yvonne Woodworth, Alexa Pulli, Mai Uchida, Stephen V. Faraone, Joseph Biederman, published by Center for Evidence-based Psychiatry
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 7 (2019): Issue 1 (January 2019)

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

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TABLE 1.

TABLE 2.

FIGURE 1.

TABLE 3.

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