CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?
BACKGROUND
In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in hyperactivity, depression/anxiety, and aggression has been identified on the child behavior checklist (CBCL-PBD profile). The aim of the present study was to estimate the prevalence of the CBCL-PBD profile in a child psychiatric sample, and to determine ICD-10 diagnoses in CBCL-PBD patients.


METHODS
We studied a sample of 939 consecutively referred children and adolescents, aged 4-18 years. ICD-10 discharge diagnoses were established in consensus conferences. The CBCL 4-18 was completed by parents as part of the diagnostic routine.


RESULTS
A total of 62 subjects (6.6%; 95% CI=5.2-8.4) met criteria for the CBCL-PBD phenotype. More than 75% of CBCL-PBD subjects were clinically diagnosed with disruptive behavior disorders (ADHD, ODD, and CD). Two patients (0.2% of the total sample) received a formal diagnosis of bipolar disorder, but did not show the CBCL-PBD phenotype.


CONCLUSIONS
A considerable number of children in Germany are referred to psychiatric care with a mixed phenotype of aggression, anxiety, depression and attention problems. Our study demonstrated a comparable prevalence and similar clinical characteristics as reported from other countries using different diagnostic approaches. However, the CBCL-PBD phenotype does not correspond with clinical consensus diagnoses of bipolar disorder, but with severe disruptive behavior disorders.
Holtmann
M
M
Department of Child and Adolescent Psychiatry and Psychotherapy, J. W. Goethe-University, Frankfurt/Main, Germany. holtmann@em.uni-frankfurt.de
Goth
K
K
Wöckel
L
L
Poustka
F
F
Bölte
S
S
D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010372:Pediatrics; D010641:Phenotype; D011569:Psychiatric Status Rating Scales