An inexpensive family index of risk for mood issues improves identification of pediatric bipolar disorder

Guillermo Perez Algorta, Eric A. Youngstrom, James Phelps, Melissa M. Jenkins, Jennifer Kogos Youngstrom, Robert L. Findling

Research output: Contribution to journalArticle

Abstract

Family history of mental illness provides important information when evaluating pediatric bipolar disorder (PBD). However, such information is often challenging to gather within clinical settings. This study investigates the feasibility and utility of gathering family history information using an inexpensive method practical for outpatient settings. Families (N = 273) completed family history, rating scales, and the Mini-International Neuropsychiatric Interview (Sheehan et al., 1998) and the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kaufman et al., 1997) about youths 5-18 (median = 11) years of age presenting to an outpatient clinic. Primary caregivers completed a half-page Family Index of Risk for Mood issues (FIRM). All families completed the FIRM quickly and easily. Most (78%) reported 1+ relatives having a history of mood or substance issues (M = 3.7, SD = 3.3). A simple sum of familial mood issues discriminated cases with PBD from all other cases (area under receiver operating characteristic [AUROC] = .63, p = .006). FIRM scores were specific to youth mood disorder and not attention-deficit/hyperactivity disorder or disruptive behavior disorder. FIRM scores significantly improved the detection of PBD even controlling for rating scales. No subset of family risk items performed better than the total. Family history information showed clinically meaningful discrimination of PBD. Two different approaches to clinical interpretation showed validity in these clinically realistic data. Inexpensive and clinically practical methods of gathering family history can help to improve the detection of PBD.

Original languageEnglish (US)
Pages (from-to)12-22
Number of pages11
JournalPsychological Assessment
Volume25
Issue number1
DOIs
StatePublished - Mar 1 2013

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Keywords

  • Assessment
  • Community mental health
  • Family history
  • Pediatric bipolar disorder
  • Screening
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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