Screening questionnaires
General psychopathology screens: the Child Behavior Checklist (CBCL) and the Child Symptom Inventory (CSI-4) are efficient screening instruments for acute mania and depression, because they assess both mood symptoms and other psychiatric behaviors and disorders that can be confused with, or may co-occur with, bipolar disorder; however, these instruments are not specific for mania and are not sufficient to make a diagnosis.[109]Achenbach TM. Manual for the child behaviour checklist/4-18 and 1991 profile. Burlington, VT: Dept Psychiatry, University of Vermont; 1991. Elevated anxiety or depression, aggression, and attention subscale scores (T scores >67) on the CBCL have previously been called the Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) phenotype, but evidence suggests that although this profile predicts later severe psychiatric symptomatology, this is not specific for bipolar disorder.[110]Holtmann M, Buchmann AF, Esser G, et al. The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. J Child Psychol Psychiatry 2011 Feb;52(2):139-47.
http://www.ncbi.nlm.nih.gov/pubmed/20854363?tool=bestpractice.com
ASEBA, University of Vermont: sample child behavior checklist
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Specific mania screens: screening instruments directed more specifically at mania or hypomania (but not sufficient for a diagnosis) include parent-completed versions of the General Behavior Inventory (P-GBI), the Child Mania Rating Scale (P-CMRS), and the Young Mania Rating Scale (P-YMRS).[111]Freeman AJ, Youngstrom EA, Frazier TW, et al. Portability of a screener for pediatric bipolar disorder to a diverse setting. Psychol Assess. 2012 Jun;24(2):341-51.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495327
http://www.ncbi.nlm.nih.gov/pubmed/21942229?tool=bestpractice.com
[112]Pavuluri MN, Henry DB, Devineni B, et al. Child mania rating scale: development, reliability, and validity. J Am Acad Child Adolesc Psychiatry. 2006 May;45(5):550-60.
http://www.ncbi.nlm.nih.gov/pubmed/16601399?tool=bestpractice.com
[113]Fristad MA, Weller ER, Weller EB. The Mania Rating Scale (MRS): further reliability and validity studies with children. Ann Clin Psychiatry. 1995 Sep;7(3):127-32.
http://www.ncbi.nlm.nih.gov/pubmed/8646272?tool=bestpractice.com
As with most other conditions in child psychiatry, cross-informant agreement is low.[94]Youngstrom E, Youngstrom JK, Starr M. Bipolar diagnoses in community mental health: Achenbach Child Behavior Checklist profiles and patterns of comorbidity. Biol Psychiatry. 2005 Oct 1;58(7):569-75.
http://www.ncbi.nlm.nih.gov/pubmed/15950197?tool=bestpractice.com
For children presenting to the emergency department, screening for immediate risk for suicidality is important.[114]Saidinejad M, Duffy S, Wallin D, et al. The management of children and youth with pediatric mental and behavioral health emergencies. Pediatrics. 2023 Sep 1;152(3).
https://publications.aap.org/pediatrics/article/152/3/e2023063255/193697/The-Management-of-Children-and-Youth-With?autologincheck=redirected
http://www.ncbi.nlm.nih.gov/pubmed/37584147?tool=bestpractice.com
Use of a brief validated screening tool for suicidality: for example, the Ask Suicide Screening Questions (ASQ) (validated in children ages 10 and over) or Columbia Suicide Severity Rating Scale for pediatrics (C-SSRC) (validated in children and adults ages 12 and over) may be helpful in this setting.[115]Horowitz LM, Bridge JA, Teach SJ, et al. Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med. 2012 Dec;166(12):1170-6.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/1363508
http://www.ncbi.nlm.nih.gov/pubmed/23027429?tool=bestpractice.com
[116]Gipson PY, Agarwala P, Opperman KJ, et al. Columbia-suicide severity rating scale: predictive validity with adolescent psychiatric emergency patients. Pediatr Emerg Care. 2015 Feb;31(2):88-94.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037572
http://www.ncbi.nlm.nih.gov/pubmed/25285389?tool=bestpractice.com
Note that screening for suicidality may also be necessary in other clinical locations: for example, primary and secondary care, depending on individual risk factors.