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The Child Behavior Checklist-Pediatric Bipolar Disorder Profile Predicts a Subsequent Diagnosis of Bipolar Disorder and Associated Impairments in ADHD Youth Growing Up: A Longitudinal Analysis

Joseph Biederman, MD; Carter R. Petty, MA; Michael C. Monuteaux, ScD; Margaret Evans, BA; Tiffany Parcell, BS; Stephen V. Faraone, PhD; and Janet Wozniak, MD

Objective: To examine the predictive utility of the Child Behavior Checklist-Pediatric Bipolar Disorder (CBCL-PBD) profile to help identify children at risk for bipolar disorder.

Method: Subjects were ascertained from 2 identically designed longitudinal case-control family studies of subjects (males and females aged 6-18 years) with DSM-III-R attention-deficit/hyperactivity disorder (ADHD). Based on data from the baseline assessment, ADHD subjects without a lifetime diagnosis of bipolar disorder were stratified by the presence (CBCL-PBD positive, N=28) or absence (CBCL-PBD negative, N=176) of a CBCL-PBD score ≥ 210 (total of attention, aggression, and anxious/depressed subscales). Subjects were comprehensively assessed at follow-up with structured psychiatric interviews. Data were collected from April 1988 to February 2003.

Results: Over a mean follow-up period of 7.4 years, a positive CBCL-PBD score predicted subsequent diagnoses of bipolar disorder, major depressive disorder, and conduct disorder, as well as impaired psychosocial functioning and higher risk for psychiatric hospitalization.

Conclusion: This work suggests that a positive CBCL-PBD score based on elevations on the attention problems, aggressive behavior, and anxious/depressed subscales predicts subsequent pediatric bipolar disorder and associated syndrome-congruent impairments. If confirmed in other studies, the CBCL-PBD score has the potential to help identify children at high risk to develop bipolar disorder.


(J Clin Psychiatry 2009;70(5):732-740. Online Ahead of Print April 21, 2009. doi:10.4088/JCP.08m04821)

Received October 20, 2008; accepted December 19, 2008. From the Clinical and Research Program in Pediatric Psychopharmacology (Drs Biederman, Monuteaux, and Wozniak; Mr Petty; and Mss Evans and Parcell) and Department of Psychiatry (Drs Biederman, Monuteaux, and Wozniak), Massachusetts General Hospital, Boston; Department of Psychiatry, Harvard Medical School, Boston (Drs Biederman, Monuteaux, and Wozniak); and Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York (Dr Faraone).

This project was supported by National Institute of Mental Health grants R01HD036317 and R03MH079954.

Financial disclosure appears at the end of the article.

Corresponding author and reprints: Joseph Biederman, MD, Clinical and Research Program in Pediatric Psychopharmacology, Yawkey Center, Suite 6A, Massachusetts General Hospital, Fruit St, Boston, MA 02114 (e-mail: