Universität zu Köln

Scott, Jan, Marwaha, Steven ORCID: 0000-0002-0303-9942, Ratheesh, Aswin, Macmillan, Iain ORCID: 0000-0002-7909-1560, Yung, Alison R., Morriss, Richard, Hickie, Ian B. and Bechdolf, Andreas (2017). Bipolar At-Risk Criteria: An Examination of Which Clinical Features Have Optimal Utility for Identifying Youth at Risk of Early Transition From Depression to Bipolar Disorders. Schizophr. Bull., 43 (4). S. 737 - 745. OXFORD: OXFORD UNIV PRESS. ISSN 1745-1701

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Abstract

Background: A clinical and research challenge is to identify which depressed youth are at risk of early transition to bipolar disorders (ET-BD). This 2-part study (1) examines the clinical utility of previously reported BD at-risk (BAR) criteria in differentiating ET-BD cases from unipolar depression (UP) controls; and (2) estimates the Number Needed to Screen (NNS) for research and general psychiatry settings. Methods: Fifty cases with reliably ascertained, ET-BD I and II cases were matched for gender and birth year with 50 UP controls who did not develop BD over 2 years. We estimated the clinical utility for finding true cases and screening out non-cases for selected risk factors and their NNS. Using a convenience sample (N = 80), we estimated the NNS when adjustments were made to account for data missing from clinical case notes. Results: Sub-threshold mania, cyclothymia, family history of BD, atypical depression symptoms and probable antidepressant-emergent elation, occurred significantly more frequently in ET-BD youth. Each of these BARD-epression criteria demonstrated clinical utility for screening out non-cases. Only cyclothymia demonstrated good utility for case finding in research settings; sub-threshold mania showed moderate utility. In the convenience sample, the NNS for each criterion ranged from similar to 4 to 7. Conclusions: Cyclothymia showed the optimum profile for case finding, screening and NNS in research settings. However, its presence or absence was only reported in 50% of case notes. Future studies of ET-BD instruments should distinguish which criteria have clinical utility for case finding vs screening.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Scott, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Marwaha, Steven UNSPECIFIED orcid.org/0000-0002-0303-9942 UNSPECIFIED Ratheesh, Aswin UNSPECIFIED UNSPECIFIED UNSPECIFIED Macmillan, Iain UNSPECIFIED orcid.org/0000-0002-7909-1560 UNSPECIFIED Yung, Alison R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Morriss, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Hickie, Ian B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bechdolf, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-226871
DOI:	10.1093/schbul/sbw154
Journal or Publication Title:	Schizophr. Bull.
Volume:	43
Number:	4
Page Range:	S. 737 - 745
Date:	2017
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1745-1701
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMORBIDITY SURVEY REPLICATION; HELP-SEEKING ADOLESCENTS; SPECTRUM DISORDERS; YOUNG-ADULTS; FOLLOW-UP; PSYCHOSIS; PREVALENCE; VALIDITY; PARENTS; MOOD Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22687