Further Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis
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y | 22 may 2023
y | 22 may 2023
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Article Category: Research Article
Publicado en línea: 22 may 2023
Páginas: 44 - 59
DOI: https://doi.org/10.2478/sjcapp-2023-0005
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© 2023 Maura DiSalvo et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Summary of studies that (A) compare rates of a positive CBCL-Bipolar (BP) profìle/Dysregulation profile (DP) in subjects with and without BP disorder, and (B) compare rates of BP disorder in subjects with and without CBCL-BP profile/DP
| A. Studies that compare rates of a positive CBCL-BP profile in subjects with and without BP disorder | |||||
|---|---|---|---|---|---|
| Diler 2009 ( |
BP: N=157(BP-1 N=79; BP-II N=3; BP-NOS N=79) (+CBCL-BP N=92) |
Structured Interview: K-SADS | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal) | Yes | 60% of children with BP disorder diagnosis had a positive CBCL-BP profile |
| Doerfler 2011 ( |
BP: N=27 (N=13 with mania; N=14 with hypomania); (+CBCL-BP N=10) |
Structured Interview: K-SADS-E | +CBCL-BP profile defined as elevated scores (T score >70) on the Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL | Yes | Children with a BP disorder diagnosis were significantly more likely to have a positive CBCL-BP profile than children with ADHD |
| Biederman 2013 ( |
BP-I: N=140 (+CBCL-BP N=80) |
Structured Interview: K-SADS-E | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal). “Intermediate” CBCL-BP profile defined as a score of ≥180 and <210 | No, duplicate sample ( |
62% of children with a BP disorder diagnosis had a positive CBCL-BP profile and 80% of profile-negative BP subjects had an intermediate (3180 <210) score |
| Uchida 2014 ( |
BP-I: N=140 (+CBCL-BP N=80) |
Structured Interview: K-SADS-E | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal) | Yes | Youth with BP disorder diagnosis were significantly more likely than both control subjects and those with ADHD to have a positive CBCL-BP profile |
| Kweon 2016 ( |
BP: N=18 (BP-I N=2; BP-II N=11; BP-NOS N=5) (+CBCL-BP N=3) |
Structured Interview: K-SADS-PL | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal) | Yes | 17% of youth with a BP disorder diagnosis had a positive CBCL-BP profile, compared to 5% of subjects with depression (NS) (limited power due to small sample size) |
| B. Studies that compare rates of BP disorder in subjects with and without CBCL-BP profile | |||||
| Volk 2007 ( |
+CBCL-BP: N=33(BP N=0)
|
Missouri Assessment for Genetics Interview for Children | +CBCL-BP profile defined as T-scores ≥70 on the Anxious/Depressed, Aggressive Behavior, and Attention Problems subscales | Yes | A positive CBCL-BP profile correlated with diagnoses of ADHD, ODD and CD as well as high rates of suicidality |
| Holtmann 2008 ( |
+CBCL-BP: N=62(BP N=0); |
ICD-10 diagnoses based on the diagnostic guidelines of the German society for child and adolescent psychiatry | +CBCL-BP profile defined as T-scores ≥70 on the Anxious/Depressed, Aggressive Behavior, and Attention Problems subscales | Yes | A positive CBCL-BP profile correlated with disruptive behavior disorders |
| McGough 2008 ( |
+CBCL-BP: N=45 (BP N=3) |
Structured Interview: K-SADS-PL | +CBCL-BP profile defined as T-scores ≥70 on the Anxious/ Depressed, Aggressive Behavior, and Attention Problems subseales |
Yes | A positive CBCL-BP profile was associated with increased generalized anxiety disorder, oppositional defiant disorder, conduct disorder, and parental substance abuse |
| Meyer 2009 ( |
+CBCL-BP: N=16 (BP diagnosis at Time 4 N=2; Time 5 N=5). |
Structured Interview | +CBCL-BP profile defined as T-score ≥60 on the Attention Problems, Aggressive Behavior, and Anxious/Depressed subscales at least once during childhood and/or adolescence (1 SD) | Yes | 31% of youth with a positive CBCL-BP profile developed BP disorder overtime |
| Biederman 2009 ( |
+CBCL-BP: N=28 (BP N=10) |
Structured Interview: Age <18: K-SADS-E Age ≥18: Structured Clinical Interview for DSM-III-R | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal) | Yes | Over a mean follow up period of 7.4 years, a positive CBCL-BP profile predicted subsequent diagnoses of bipolar disorder, major depressive disorder and conduct disorder, as well as impaired psychosocial functioning and higher risk for psychiatric hospitalization |
| Althoff 2010 ( |
+CBCL-BP: N=57 (BP N=O) Comparison subjects: N= 1516 (BP N=6) |
Structured interview: Composite International Diagnostic Interview (ClDI) | +CBCL-EP profile defined by latent class analysis (LCA) as the class with the highest elevations on the Attention Problems, Aggressive Behavior, and Anxious/Depressed subscales. No specific cutoff was reported in the paper | Yes | The presence of a positive CBCL-BP profile at Wave 1 in childhood was associated with increased rates of adult anxiety disorders, mood disorders, disruptive behavior disorders, and drug abuse 14 years later |
| Biederman 2012 ( |
ADHD and +CBCL-BP: N=45 |
Structured Interview: Age <18: K-SADS-E Age ≥18: Structured Clinical Interview for DSM-III-R and DSM-IV Axis 1 Disorders | +CBCL-EP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal). CBCL-DESR defined as a score of ≥180 and <210 | No, duplicate sample ( |
Children with ADHD and a positive CBCL-BP profile had more impairing ADHD symptoms, higher rates of psychiatric hospitalizations, and higher rates of CD, ODD, and bipolar disorder compared to ADHD and control subjects |
| Wilens 2013 ( |
+CBCL-BP: N=43 (BP N=35) |
Structured Interview: Age <18: K-SADS-E |
+CBCL-EP profile defined as sum of scores on Anxíety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal). CBCL-DESR defined as a score of ≥180 and <210 | Yes | Subjects with a positive CBCL-BP profile had higher risk for psychiatric disorders including BP disorder, CD, multiple anxiety disorders, and ADHD |
| Mbekou 2014 ( |
+CBCL-BP: N=150 (BP N=10) |
DSM-IV-TR diagnostic information was obtained from patients’ clinical files and included for analyses. | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal) | Yes | There were no significant differences in the number of youths diagnosed with BP disorder in children with a positive CBCL-BP profile versus those with a negative profile |
| Peyre 2015 ( |
+CBCL-BP: N=42(BP N=1); |
Structured Interview: K-SADS-PL | +CBCL-BP profile defined as T-scores >70 on the Attention Problems, Aggressive Behavior, and Anxious/Depressed subscales of the CBCL | Yes | A positive CBCL-BP profile was associated with ODD, anxiety disorders, MDD, emotionality, and “self-directness” |
| Caporino 2016 ( |
+CBCL-BP: N=17 (BP N=0) |
Structured interview: Composite International Diagnostic Interview (ClDI) | Latent profile analysis (LPA) was used to stratify patients into dysregulated (+CBCL-BP) versus non-dysregulated based on CBCL Attention Problems, Aggressive Behavior, and Anxious/Depressed subscale scores. |
No, neither group developed BP disorder by follow-up | At the 7- to 19- year follow-up, the dysregulated group had significantly higher rates of PTSD, agoraphobia, panic attacks, and QCD within the last year, as well as rates of lifetime PTSD |
| Dolitzsch 2016 ( |
+CBCL-BP: N=32 (BP N=2); |
Structured Interview: K-SADS-PL | +CBCL-BP profile defined as having a T-score ≥67 on the Anxious/Depressed, Attention Problems, and Aggressive Behavior subscales of the CBCL | Yes | A positive CBCL-BP profile carried a high (>2) relative risk for manic episodes, bipolar disorder, cyclothymia, hyperkinetic conduct disorder, mixed disorders of conduct and emotion, and suicidal ideation |
| Joshi 2018 ( |
ASD with +CBCL-BP: N=44 (BP N=20) |
Structured Interview: K-SADS-E | +CBCL-BP profile defined as sum of scores on Anxiety/Depression, Attention Problems, and Aggressive Behaviors subscales of the CBCL with a cut off score of 210 or higher (2 SD above normal) | Yes | ASD youth with a positive CBCL-BP profile had a greater severity of autism, significantly higher rates of disruptive behavior disorders, MDD, and BP disorder, and had more psychosocial dysfunction |