Variability among research diagnostic interview instruments in the application of DSM-IV-TR criteria for pediatric bipolar disorder

Cathryn A. Galanter, Stephanie R. Hundt, Parag Goyal, Jenna Le, Prudence W. Fisher

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objective: The DSM-IV-TR criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and validity, but vary in how they incorporate DSM-IV-TR criteria for pediatric BD. Method: We examined DSM-IV-TR criteria and the descriptive text for a manic episode and the mania sections of six commonly used pediatric diagnostic research interviews focusing on the following: interpretation of DSM-IV-TR, recommendations for administration, and scoring methods. Results: There are differences between the DSM-IV-TR manic episode criteria and descriptive text. Instruments vary in several ways including in their conceptualization of the mood criterion, whether symptoms must represent a change from the child's usual state, and whether B-criteria are required to co-occur with the A-criterion. Instruments also differ on recommendations for administration and scoring methods. Conclusions: Given the differences between DSM-IV-TR manic episode criteria and explanatory text, it is not surprising that there is considerable variation between diagnostic instruments based on DSM-IV-TR. These differences likely lead to dissimilarities in subjects included in BD research studies and inconsistent findings across studies. The field of child psychiatry would benefit from more uniform methods of assessing symptoms and determining pediatric BD diagnoses. We discuss recommendations for changes to future instruments, interviews, assessment, and the DSM-5.

Original languageEnglish (US)
Pages (from-to)605-621
Number of pages17
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume51
Issue number6
DOIs
StatePublished - Jun 2012

Keywords

  • assessment
  • bipolar disorder
  • diagnosis
  • diagnostic interview
  • pediatric

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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