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
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: |
|
||||||||||||||||||||||||||||||||||||
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: |
|
||||||||||||||||||||||||||||||||||||
Refereed: | Yes | ||||||||||||||||||||||||||||||||||||
URI: | http://kups.ub.uni-koeln.de/id/eprint/22687 |
Downloads
Downloads per month over past year
Altmetric
Export
Actions (login required)
![]() |
View Item |