Bipolar disorder in the young - brief screening tool identified

The Conners Abbreviated Parent Questionnaire was found to be a useful screening tool for a pre-pubertal and early adolescent bipolar disorder phenotype in a study that included subjects with ADHD.Studies in bipolar disorder are hampered by the lack of a published screening tool for pre-pubertal and early adolescent bipolar disorder phenotype that is comparable to screening tools for adult bipolar disorder, say the study authors. Since there is a high incidence of co-morbid attention deficit/hyperactivity disorder (ADHD) in subjects with this disorder, any screening tool needs to distinguish between ADHD and mania.The researchers set out to ascertain whether the 10-item Conners Abbreviated Parent Questionnaire, a tool that was developed to aid in the assessment of ADHD, might be of use.The study involved 92 patients with a pre-pubertal and early adolescent bipolar disorder phenotype together with 80 patients with ADHD and 92 healthy comparison subjects. All patients were aged between seven and 16 years.Subjects in the bipolar group were required to display at least one of the two cardinal symptoms of mania (ie, elation and/or grandiosity) to prevent diagnosis of mania only on the basis of symptoms that overlap with ADHD (eg, hyperactivity).Parents and children were assessed separately using the Washington University in St Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS). Prior to this, parents also completed the Conners Abbreviated Parent Questionnaire.Scores for items 7, 8, 9 and 10 of the questionnaire were found to be significantly higher in the bipolar group than in the ADHD group. The researchers used receiver operating characteristic methods to analyse data from the questionnaire, determining that the algorithm ([2 x item 8 score] + item 9 score) provided the best screen for a pre-pubertal and early adolescent bipolar disorder phenotype.Employment of this algorithm using age as a covariate resulted in a sensitivity of 0.73 and a specificity of 0.86. These values are comparable to those reported for screening tools for adult bipolar disorder.The researchers conclude that the Conners Abbreviated Parent Questionnaire is an easy-to-complete scale that provided good psychometrics as a screen for an outpatient pre-pubertal and early adolescent bipolar disorder phenotype in a study of children and adolescents that included subjects with ADHD.Reference...