Developing a 10-Item Mania Scale From the Parent General Behavior Inventory for Children and Adolescents
J Clin Psychiatry 2008;69(5):831-839
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Bipolar disorder is being diagnosed and treated in
children and adolescents at a rapidly increasing rate, despite the lack of
validated instruments to help screen for the condition or differentiate it from
more common disorders. The goal of the present study was to develop and
validate a brief (10 item) instrument to assess mania in a large sample of
outpatients presenting with a variety of different DSM-IV diagnoses, including
frequent comorbid conditions.
Method: Parents presenting to a Midwestern academic outpatient
medical center for psychiatric evaluation of their child completed the Parent
General Behavior Inventory (P-GBI), a 73-item mood inventory that comprises a
46-item depressive symptom scale and a 28-item hypomanic/biphasic scale (1 item
is used in both scales), as part of a screening assessment that included a
semistructured psychiatric interview of both the parent and the child to
determine the child's diagnoses. The study was conducted between the years 1999
Results: Six hundred thirty-seven youths received a diagnostic
assessment with either the Epidemiologic or Present and Lifetime Version of the
Schedule for Affective Disorders and Schizophrenia for School-Age Children. A
10-item form derived from the 73-item P-GBI had good reliability (alpha = .92),
correlated (r = 0.95) with the 28-item scale, and showed significantly better
discrimination of bipolar disorders (area under the receiving operating
characteristic [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p <
.005), with good precision for estimation of individual scores for cases up to
2 standard deviations elevated on the latent trait. The 10-item scale also did
well discriminating bipolar from unipolar (AUROC = 0.86) and bipolar from
attention-deficit/hyperactivity disorder (AUROC = 0.82) cases.
Conclusions: Findings suggest that parents most notice elated
mood, high energy, irritability, and rapid changes in mood and energy as the
prominent features of juvenile bipolar disorder.