M Holtmann1, K Goth, L Wöckel, F Poustka, S Bölte. 1. Department of Child and Adolescent Psychiatry and Psychotherapy, J. W. Goethe-University, Frankfurt/Main, Germany. holtmann@em.uni-frankfurt.de
Abstract
BACKGROUND: In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in hyperactivity, depression/anxiety, and aggression has been identified on the child behavior checklist (CBCL-PBD profile). The aim of the present study was to estimate the prevalence of the CBCL-PBD profile in a child psychiatric sample, and to determine ICD-10 diagnoses in CBCL-PBD patients. METHODS: We studied a sample of 939 consecutively referred children and adolescents, aged 4-18 years. ICD-10 discharge diagnoses were established in consensus conferences. The CBCL 4-18 was completed by parents as part of the diagnostic routine. RESULTS: A total of 62 subjects (6.6%; 95% CI=5.2-8.4) met criteria for the CBCL-PBD phenotype. More than 75% of CBCL-PBD subjects were clinically diagnosed with disruptive behavior disorders (ADHD, ODD, and CD). Two patients (0.2% of the total sample) received a formal diagnosis of bipolar disorder, but did not show the CBCL-PBD phenotype. CONCLUSIONS: A considerable number of children in Germany are referred to psychiatric care with a mixed phenotype of aggression, anxiety, depression and attention problems. Our study demonstrated a comparable prevalence and similar clinical characteristics as reported from other countries using different diagnostic approaches. However, the CBCL-PBD phenotype does not correspond with clinical consensus diagnoses of bipolar disorder, but with severe disruptive behavior disorders.
BACKGROUND: In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in hyperactivity, depression/anxiety, and aggression has been identified on the child behavior checklist (CBCL-PBD profile). The aim of the present study was to estimate the prevalence of the CBCL-PBD profile in a childpsychiatric sample, and to determine ICD-10 diagnoses in CBCL-PBD patients. METHODS: We studied a sample of 939 consecutively referred children and adolescents, aged 4-18 years. ICD-10 discharge diagnoses were established in consensus conferences. The CBCL 4-18 was completed by parents as part of the diagnostic routine. RESULTS: A total of 62 subjects (6.6%; 95% CI=5.2-8.4) met criteria for the CBCL-PBD phenotype. More than 75% of CBCL-PBD subjects were clinically diagnosed with disruptive behavior disorders (ADHD, ODD, and CD). Two patients (0.2% of the total sample) received a formal diagnosis of bipolar disorder, but did not show the CBCL-PBD phenotype. CONCLUSIONS: A considerable number of children in Germany are referred to psychiatric care with a mixed phenotype of aggression, anxiety, depression and attention problems. Our study demonstrated a comparable prevalence and similar clinical characteristics as reported from other countries using different diagnostic approaches. However, the CBCL-PBD phenotype does not correspond with clinical consensus diagnoses of bipolar disorder, but with severe disruptive behavior disorders.
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