Bipolar diagnoses in community mental health: Achenbach Child Behavior Checklist profiles and patterns of comorbidity.
BACKGROUND
There are converging findings about pediatric bipolar disorder (PBD) in terms of associated comorbidity and behavior problem profiles on the Achenbach Child Behavior Checklist (CBCL). However, no study has examined clinical or demographic characteristics of youths clinically diagnosed with bipolar disorder in a low-income, diverse community clinical sample.


METHODS
Archival data (N = 3086 cases) from six urban community mental health centers (CMHC) were reviewed to determine the base rate of bipolar disorder and the demographic and clinical characteristics (comorbidity and CBCL profiles) associated with the diagnosis.


RESULTS
Roughly 6% of the sample received clinical diagnoses of PBD. Patterns of comorbidity and CBCL profiles were highly similar to published samples. However, elevated CBCL scores were not specific to bipolar disorder, since they were also frequently high for nonbipolar cases.


CONCLUSIONS
There appears to be substantial convergence between the demographic and clinical characteristics of cases clinically diagnosed with PBD versus those diagnosed with semistructured research interviews, strengthening the validity of both sets of diagnoses. At the same time, the CBCL appears to do poorly discriminating clinical diagnoses of PBD, due to the pervasive externalizing behavior problems in CMHC samples and the variable presentation of PBD cases.
Youngstrom
Eric
E
Department of Psychology, Case Western Reserve University, Cleveland, Ohio 44106-7123, USA. Eric.Youngstrom@case.edu
Youngstrom
Jennifer Kogos
JK
Starr
Maryjean
M
D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D003156:Community Mental Health Services; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D011569:Psychiatric Status Rating Scales; D014505:Urban Population