title: Personal and familial correlates of bipolar (BP)-I disorder in children with a diagnosis of BP-I disorder with a positive child behavior checklist (CBCL)-severe dysregulation profile: a controlled study.
abstract: BACKGROUND
  Although the DSM-IV provides explicit criteria for the diagnosis of BP-I disorder, this is a complex diagnosis that requires high levels of clinical expertise. Previous work shows children with a unique profile of the CBCL of high scores (2SD) on the attention problems (AP), aggressive behavior (AGG), and anxious-depressed (AD) (A-A-A) subscales are more likely than other children to meet criteria for BP-I disorder in both epidemiological and clinical samples. However, since not all BP-I disorder children have a positive profile questions remain as to its informativeness, particularly in the absence of an expert diagnostician.
  
  
  METHODS
  Analyses were conducted comparing personal and familial correlates of BP-I disorder in 140 youth with a structured interview and an expert clinician based DSM-IV diagnosis of BP-I disorder with (N=80) and without (N=60) a positive CBCL- Severe Dysregulation profile, and 129 controls of similar age and sex without ADHD or a mood disorder. Subjects were comprehensively assessed with structured diagnostic interviews and wide range of functional measures. We defined the CBCL-severe dysregulation profile as an aggregate cut-off score of ≥ 210 on the A-A-A scales.
  
  
  RESULTS
  BP-I probands with and without a positive CBCL-severe dysregulation profile significantly differed from Controls in patterns of psychiatric comorbidity, psychosocial and psychoeducational dysfunction, and cognitive deficits, as well as in their risk for BP-I disorder in first degree relatives.
  
  
  CONCLUSIONS
  Because the sample was referred and largely Caucasian, findings may not generalize to community samples and other ethnic groups.
  
  
  CONCLUSIONS
  A positive CBCL-severe dysregulation profile identifies a severe subgroup of BP-I disorder youth.
authors.affiliation: Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114, United States. jbiederman@partners.org
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Marykate
authors.initials: M
authors.lastname: Martelon
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: K Yvonne
authors.initials: KY
authors.lastname: Woodworth
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spencer
authors.forename: Janet R
authors.initials: JR
authors.lastname: Wozniak
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D057189:Checklist; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000453:epidemiology