The Child Behavior Checklist (CBCL) and the CBCL-Bipolar Phenotype Are Not Useful in Diagnosing Pediatric Bipolar Disorder
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OBJECTIVES: Previous studies have suggested that the sum of Attention, Aggression, and Anxious/Depressed subscales of Child Behavior Checklist (CBCL-PBD; pediatric bipolar disorder phenotype) may be specific to pediatric bipolar disorder (BP). The purpose of this study was to evaluate the usefulness of the CBCL and CBCL-PBD to identify BP in children <12 years old. METHODS: A sample of children with BP I, II, and not otherwise specified (NOS) (n = 157) ascertained through the Course and Outcome for Bipolar Disorder in Youth (COBY) study were compared with a group of children with major depressive/anxiety disorders (MDD/ANX; n = 101), disruptive behavior disorder (DBD) (n = 127), and healthy control (HC) (n = 128). The CBCL T-scores and area under the curve (AUC) scores were calculated and compared among the above-noted groups. RESULTS: Forty one percent of BP children did not have significantly elevated CBCL-PBD scores (>or=2 standard deviations [SD]). The sensitivity and specificity of CBCL-PBD >or= 2 SD for diagnosis of BP was 57% and 70-77%, respectively, and the accuracy of CBCL-PBD for identifying a BP diagnosis was moderate (AUC = 0.72-0.78). CONCLUSION: The CBCL and the CBCL-PBD showed that BP children have more severe psychopathology than HC and children with other psychopathology, but they were not useful as a proxy for Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) diagnosis of BP.
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Scores on questionnaires such as the Child Behaviour Checklist dysregulation phenotype have poor capacity for differentiating BD from other complex and severe symptomatic presentations.
“However, scores on such questionnaires as the Child Behaviour Checklist (CBCL) “dysregulation phenotype”, previously described as “BD phenotype”, have poor capacity for differentiating BD from other complex and severe symptomatic presentations.580”
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- Authors
- Diler, R. S., Birmaher, B., Axelson, D., Goldstein, B., Gill, M., Strober, M., Kolko, D. J., Goldstein, T. R., Hunt, J., Yang, M., Ryan, N. D., Iyengar, S., Dahl, R. E., Dorn, L. D., & Keller, M. B.
- Affiliations
- University of Pittsburgh Medical Center (US)
- University of California, Los Angeles (US)
- Brown University (US)
- University of Pittsburgh (US)
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Diler, Rasim Somer
- ORCID
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2009-02
- Volume
- 19
- Issue
- 1
- Pages
- 23-30
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- PMC
- PMC2753490
- OpenAlex
- W2038496130
- Cited by
- 99
- References
- 31
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 4 · 2021: 1 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 14 · 2014: 5 · 2013: 7 · 2012: 10
- FWCI
- 5.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH059929, P01MH041712, R01MH057727, R01MH112543, R01MH059691)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- pediatric bipolar disorder, Child Behavior Checklist, diagnostic accuracy, attention deficits, aggression, anxious/depressed symptoms, disruptive behavior disorders, major depressive disorder, anxiety disorders, children, psychopathology
- MeSH terms
- Anxiety Disorders, Bipolar Disorder, Child, Child Behavior, Major Depressive Disorder, Diagnosis, Differential, Female, Humans, Interview, Psychological, Male, Personality Assessment, Phenotype, Psychiatric Status Rating Scales, ROC Curve, Sensitivity and Specificity, Area Under Curve, Attention Deficit and Disruptive Behavior Disorders
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