Evidence-Based Assessment of Pediatric Bipolar Disorder, Part II: Incorporating Information From Behavior Checklists

Abstract

The previous commentary described how to gather and use information about the base rate of pediatric bipolar disorder (PBD) and the family history of bipolar illness to assess the risk of PBD for an individual case, using an evidence-based practice (EBP) framework. This month's column continues with that case and demonstrates how behavior rating scales or checklists are another inexpensive and potentially useful source of information. This column shows how to make use of likelihood ratios (how much more likely a disorder is to be present than absent for a given test score in a defined population [ Guyatt and Rennie, 2002 Guyatt GH Rennie D Users' Guides to the Medical Literature. AMA Press, Chicago2002 Google Scholar ) to assess the likelihood of PBD in an individual case. Likelihood ratios are valuable because they may enable a clinician to take a legitimate shortcut and use an easier to administer diagnostic test (here the Child Behavior Checklist [CBCL]) in place of a more time-consuming but definitive test (here the Schedule for Affective Disorders and Schizophrenia for School-Age Children [ Kaufman et al., 1997 Kaufman J Birmaher B Brent D et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36: 980-988 Abstract Full Text PDF PubMed Scopus (7063) Google Scholar ]). The specific details of the case have been changed so that the person described is not recognizable.