Convergence between structured diagnostic interviews and clinical assessment on the diagnosis of pediatric-onset mania.
BACKGROUND
Uncertainties remain as to the utility of structured diagnostic methodology to aid in the diagnosis of manic symptomatology in youth. To this end, this study compared structured diagnostic interview based diagnoses of mania in children and adolescents with that of an expert clinician.


METHODS
We separately and independently assessed 69 youths recruited for a study of mania in childhood, all but 2 of whom experienced mania, with a structured diagnostic interview administered by trained psychometricians and a clinical assessment by a board-certified child and adolescent psychiatrist (JW) who was blind to the structured interview results.


RESULTS
Structured interviews and clinical evaluations converged in all but two cases (67 of 69 or 97% agreement). In one discrepant case, the structured interview diagnosed a full case of mania, but the clinical interview diagnosed cyclothymia/subthreshold mania; in the other discrepant case, the structured interview failed to diagnose mania, but the clinical interview did diagnose mania.


CONCLUSIONS
In children referred for evaluation of suspected bipolar disorder, a structured interview diagnosis of mania is very likely to be corroborated by a clinical interview.
Wozniak
Janet
J
Pediatric Psychopharmacology Unit, Psychiatry Service, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Monuteaux
Michael
M
Richards
Jennifer
J
E  Lail
Kathryn
K
Faraone
Stephen V
SV
Biederman
Joseph
J
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods; D015203:Reproducibility of Results; D016037:Single-Blind Method