The Bipolar Prodrome Symptom Interview and Scale–Prospective (BPSS-P): description and validation in a psychiatric sample and healthy controls
Corresponding Author
Christoph U Correll
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Albert Einstein College of Medicine, Bronx, NY, USA
Drs. Correll and Olvet contributed equally to this manuscript.Corresponding author:
Christoph U. Correll, M.D.
The Zucker Hillside Hospital
Psychiatry Research
Glen Oaks, NY 11004
USA
Fax: 718-343-1659
E-mail: [email protected]
Search for more papers by this authorDoreen M Olvet
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, USA
Drs. Correll and Olvet contributed equally to this manuscript.Search for more papers by this authorAndrea M Auther
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorMarta Hauser
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorTaishiro Kishimoto
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Keio University School of Medicine, Shinjuku, Tokyo, Japan
Search for more papers by this authorRicardo E Carrión
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
Search for more papers by this authorStephanie Snyder
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorBarbara A Cornblatt
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorCorresponding Author
Christoph U Correll
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Albert Einstein College of Medicine, Bronx, NY, USA
Drs. Correll and Olvet contributed equally to this manuscript.Corresponding author:
Christoph U. Correll, M.D.
The Zucker Hillside Hospital
Psychiatry Research
Glen Oaks, NY 11004
USA
Fax: 718-343-1659
E-mail: [email protected]
Search for more papers by this authorDoreen M Olvet
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, USA
Drs. Correll and Olvet contributed equally to this manuscript.Search for more papers by this authorAndrea M Auther
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorMarta Hauser
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorTaishiro Kishimoto
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Keio University School of Medicine, Shinjuku, Tokyo, Japan
Search for more papers by this authorRicardo E Carrión
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
Search for more papers by this authorStephanie Snyder
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorBarbara A Cornblatt
The Zucker Hillside Hospital, Psychiatry Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
Search for more papers by this authorAbstract
Objective
The aim of the present study was to investigate the psychometric properties of the Bipolar Prodrome Symptom Interview and Scale–Prospective (BPSS-P), the first specific interview for emerging bipolar disorder (BD) symptoms.
Methods
A total of 205 youth aged 12–23 years and/or their caregivers underwent BPSS-P interviews: 129 patients with mood spectrum disorders [depression spectrum disorder (n = 77), mood disorder not otherwise specified (NOS) (n = 27), BD-NOS (n = 14), bipolar I disorder (BD-I)/bipolar II disorder (BD-II)/cyclothymia (n = 11), 34 with non-mood spectrum disorders, and 42 healthy controls (HCs)]. We used Cronbach's α to assess internal consistency; intra-class correlation (ICC) for inter-rater reliability; Spearman's rho for convergent validity with the Young Mania Rating Scale (YMRS), General Behavior Inventory–10-item Mania Form (GBI-M-10), and Cyclothymic–Hypersensitive Temperament (CHT) scale; and analysis of variance for discriminatory power between diagnostic groups.
Results
Internal consistency was good to very good for the BPSS-P Mania (Cronbach's α = 0.87), Depression (Cronbach's α = 0.89), and General Symptom indices (Cronbach's α = 0.74). Inter-rater reliability was high for the BPSS-P Total score (ICC = 0.939), and BPSS-P Mania (ICC = 0.934), Depression (ICC = 0.985), and General (ICC = 0.981) indices. Convergent validity was large (ρ ≥ 0.50) between the BPSS-P Mania Index and YMRS, GBI-M-10, and CHT; BPSS-P Depression Index and Montgomery–Åsberg Depression Rating Scale (MADRS) and CHT; and BPSS-P General Index and GBI-M-10 and CHT. Expectedly, convergent validity was small (ρ = 0.10 to < 0.30) between the BPSS-P Mania Index and MADRS, and BPSS-P Depression Index and YMRS. Furthermore, the BPSS-P and its subscales discriminated each patient group from HCs and from non-mood spectrum patients (except for the BPSS-P General Index). Moreover, the BPSS-P Total score discriminated BD-I/BD-II/cyclothymia from depression spectrum patients, and the BPSS-Mania Index differentiated all three bipolar spectrum groups from depression spectrum patients.
Conclusions
The BPSS-P has good to excellent psychometric properties. Its use across multiple settings and predictive validity requires further investigation.
References
- 1Correll CU, Penzner JB, Lencz T et al. Early identification and high-risk strategies for bipolar disorder. Bipolar Disord 2007; 9: 324–338.
- 2Bauer M, Juckel G, Correll CU, Leopold K, Pfennig A. Diagnosis and treatment in the early phase of bipolar disorders. Eur Arch Psychiatry Clin Neurosci 2008; 258 (Suppl. 5): 50–54.
- 3Bechdolf A, Nelson B, Cotton SM et al. A preliminary evaluation of the validity of at-risk criteria for bipolar disorders in help-seeking adolescents and young adults. J Affect Disord 2010; 127: 316–320.
- 4Conus P, Ward J, Lucas N et al. Characterisation of the prodrome to a first episode of psychotic mania: results of a retrospective study. J Affect Disord 2010; 124: 341–345.
- 5Luby JL, Navsaria N. Pediatric bipolar disorder: evidence for prodromal states and early markers. J Child Psychol Psychiatry 2010; 51: 459–471.
- 6Skjelstad DV, Malt UF, Holte A. Symptoms and signs of the initial prodrome of bipolar disorder: a systematic review. J Affect Disord 2010; 126: 1–13.
- 7Pavuluri MN. Effects of early intervention on the course of bipolar disorder: theories and realities. Curr Psychiatry Rep 2010; 12: 490–498.
- 8McNamara RK, Nandagopal JJ, Strakowski SM, DelBello MP. Preventative strategies for early-onset bipolar disorder: towards a clinical staging model. CNS Drugs 2010; 24: 983–996.
- 9Leopold K, Ritter P, Correll CU et al. Risk constellations prior to the development of bipolar disorders: rationale of a new risk assessment tool. J Affect Disord 2012; 136: 1000–1010.
- 10Brietzke E, Mansur RB, Soczynska JK, Kapczinski F, Bressan RA, McIntyre RS. Towards a multifactorial approach for prediction of bipolar disorder in at risk populations. J Affect Disord 2012; 140: 82–91.
- 11Lapalme M, Hodgins S, LaRoche C. Children of parents with bipolar disorder: a metaanalysis of risk for mental disorders. Can J Psychiatry 1997; 42: 623–631.
- 12Chang KD, Steiner H, Ketter TA. Psychiatric phenomenology of child and adolescent bipolar offspring. J Am Acad Child Adolesc Psychiatry 2000; 39: 453–460.
- 13DelBello MP, Geller B. Review of studies of child and adolescent offspring of bipolar parents. Bipolar Disord 2001; 3: 325–334.
- 14Chang K, Steiner H, Ketter T. Studies of offspring of parents with bipolar disorder. Am J Med Genet C Semin Med Genet 2003; 123: 26–35.
- 15Egeland JA, Shaw JA, Endicott J et al. Prospective study of prodromal features for bipolarity in well Amish children. J Am Acad Child Adolesc Psychiatry 2003; 42: 786–796.
- 16Findling RL, Youngstrom EA, McNamara NK et al. Early symptoms of mania and the role of parental risk. Bipolar Disord 2005; 7: 623–634.
- 17Henin A, Biederman J, Mick E et al. Psychopathology in the offspring of parents with bipolar disorder: a controlled study. Biol Psychiatry 2005; 58: 554–561.
- 18Hillegers MH, Reichart CG, Wals M, Verhulst FC, Ormel J, Nolen WA. Five-year prospective outcome of psychopathology in the adolescent offspring of bipolar parents. Bipolar Disord 2005; 7: 344–350.
- 19Duffy A, Alda M, Crawford L, Milin R, Grof P. The early manifestations of bipolar disorder: a longitudinal prospective study of the offspring of bipolar parents. Bipolar Disord 2007; 9: 828–838.
- 20Duffy A. The early course of bipolar disorder in youth at familial risk. J Can Acad Child Adolesc Psychiatry 2009; 18: 200–205.
- 21Duffy A, Alda M, Hajek T, Sherry SB, Grof P. Early stages in the development of bipolar disorder. J Affect Disord 2010; 121: 127–135.
- 22Correll CU, Hauser M, Auther AM, Cornblatt BA. Research in people with psychosis risk syndrome: a review of the current evidence and future directions. J Child Psychol Psychiatry 2010; 514: 390–431.
- 23Fusar-Poli P, Bonoldi I, Yung AR et al. Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 2012; 69: 220–229.
- 24Berk M, Conus P, Lucas N et al. Setting the stage: from prodrome to treatment resistance in bipolar disorder. Bipolar Disord 2007; 9: 671–678.
- 25Correll CU, Penzner JB, Frederickson AM et al. Differentiation in the preonset phases of schizophrenia and mood disorders: evidence in support of a bipolar mania prodrome. Schizophr Bull 2007; 33: 703–714.
- 26Hauser M, Pfennig A, Ozgürdal S, Heinz A, Bauer M, Juckel G. Early recognition of bipolar disorder. Eur Psychiatry 2007; 22: 92–98.
- 27Conus P, Ward J, Hallam KT et al. The proximal prodrome to first episode mania – a new target for early intervention. Bipolar Disord 2008; 10: 555–565.
- 28Miklowitz DJ, Chang KD. Prevention of bipolar disorder in at-risk children: theoretical assumptions and empirical foundations. Dev Psychopathol 2008; 20: 881–897.
- 29Bechdolf A, Ratheesh A, Wood SJ et al. Rationale and first results of developing at-risk (prodromal) criteria for bipolar disorder. Curr Pharm Des 2012; 18: 358–375.
- 30Howes OD, Lim S, Theologos G, Yung AR, Goodwin GM, McGuire P. A comprehensive review and model of putative prodromal features of bipolar affective disorder. Psychol Med 2011; 41: 1567–1577.
- 31Lish JD, Dime-Meenan S, Whybrow PC, Price RA, Hirschfeld RM. The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members. J Affect Disord 1994; 31: 281–294.
- 32Perlis RH, Miyahara S, Marangell LB et al. STEP-BD Investigators: long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychiatry 2004; 55: 875–881.
- 33DelBello MP, Adler CM, Whitsel RM, Stanford KE, Strakowski SM. A 12-week single-blind trial of quetiapine for the treatment of mood symptoms in adolescents at high risk for developing bipolar I disorder. J Clin Psychiatry 2007; 68: 789–795.
- 34Findling RL, Frazier TW, Youngstrom EA et al. Double-blind, placebo-controlled trial of divalproex monotherapy in the treatment of symptomatic youth at high risk for developing bipolar disorder. J Clin Psychiatry 2007; 68: 781–788.
- 35Hauser M, Correll CU. The significance of at-risk or prodromal symptoms of bipolar I disorder in children and adolescents. Can J Psychiatry 2013; 58: 22–31.
- 36Häfner H, an der Heiden W. The course of schizophrenia in the light of modern follow-up studies: the ABC and WHO studies. Eur Arch Psychiatry Clin Neurosci 1999; 249 (Suppl. 4): 14–26.
- 37Hegerl U, Bottner AC, Holtschmidt-Täschner B et al. Onset of depressive episodes is faster in patients with bipolar versus unipolar depressive disorder: evidence from a retrospective comparative study. J Clin Psychiatry 2008; 69: 1075–1080.
- 38 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: APA, 1994.
- 39Leibenluft E, Charney DS, Towbin KE, Bhangoo RK, Pine DS. Defining clinical phenotypes of juvenile mania. Am J Psychiatry 2003; 160: 430–437.
- 40Geller B, Luby JL, Joshi P et al. A randomized controlled trial of risperidone, lithium, or divalproex sodium for initial treatment of bipolar I disorder, manic or mixed phase, in children and adolescents. Arch Gen Psychiatry 2012; 69: 515–528.
- 41Olvet DM, Stearns WH, McLaughlin D, Auther AM, Correll CU, Cornblatt BA. Comparing clinical and neurocognitive features of the schizophrenia prodrome to the bipolar prodrome. Schizophr Res 2010; 123: 59–63.
- 42Tijssen MJ, Van Os J, Wittchen HU, Lieb R, Beesdo K, Wichers M. Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community. Acta Psychiatr Scand 2010; 122: 255–266.
- 43Nadkarni RB, Fristad MA. Clinical course of children with a depressive spectrum disorder and transient manic symptoms. Bipolar Disord 2010; 12: 494–503.
- 44Bechdolf A, Ratheesh A, Cotton SM et al. The predictive validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospective study. Bipolar Disord 2014; in press.
- 45Depue RA, Slater JF, Wolfstetter-Kausch H, Klein D, Goplerud E, Farr D. A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: a conceptual framework and five validation studies. J Abnorm Psychol 1981; 90: 381–437.
- 46Depue RA, Krauss S, Spoont MR, Arbisi P. General behavior inventory identification of unipolar and bipolar affective conditions in a nonclinical university population. J Abnorm Psychol 1989; 98: 117–126.
- 47Klein DN, Depue RA. Continued impairment in persons at risk for bipolar affective disorder: results of a 19-month follow-up study. J Abnorm Psychol 1984; 93: 345–347.
- 48Klein DN, Depue RA, Slater JF. Cyclothymia in the adolescent offspring of parents with bipolar affective disorder. J Abnorm Psychol 1985; 94: 115–127.
- 49Klein DN, Depue RA, Slater JF. Inventory identification of cyclothymia. IX. Validation in offspring of bipolar I patients. Arch Gen Psychiatry 1986; 43: 441–445.
- 50Reichart CG, van der Ende J, Wals M et al. The use of the GBI in a population of adolescent offspring of parents with a bipolar disorder. J Affect Disord 2004; 80: 263–267.
- 51Youngstrom EA, Findling RL, Danielson CK, Calabrese JR. Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory. Psychol Assess 2001; 13: 267–276.
- 52Findling RL, Youngstrom EA, Danielson CK et al. Clinical decision-making using the General Behavior Inventory in juvenile bipolarity. Bipolar Disord 2002; 4: 34–42.
- 53Reichart CG, van der Ende J, Wals M et al. The use of the GBI as predictor of bipolar disorder in a population of adolescent offspring of parents with a bipolar disorder. J Affect Disord 2005; 89: 147–155.
- 54Meyer B, Johnson SL, Carver CS. Exploring behavioral activation and inhibition sensitivities among college students at risk for bipolar spectrum symptomatology. J Psychopathol Behav Assess 1999; 21: 275–292.
- 55Danielson CK, Youngstrom EA, Findling RL, Calabrese JR. Discriminative validity of the general behavior inventory using youth report. J Abnorm Child Psychol 2003; 31: 29–39.
- 56Youngstrom EA, Findling RL, Calabrese JR et al. Comparing the diagnostic accuracy of six potential screening instruments for bipolar disorder in youths aged 5 to 17 years. J Am Acad Child Adolesc Psychiatry 2004; 43: 847–858.
- 57Youngstrom E, Meyers O, Demeter C et al. Comparing diagnostic checklists for pediatric bipolar disorder in academic and community mental health settings. Bipolar Disord 2005; 7: 507–517.
- 58Fristad MA, Frazier TW, Youngstrom EA et al. What differentiates children visiting outpatient mental health services with bipolar spectrum disorder from children with other psychiatric diagnoses? Bipolar Disord 2012; 14: 497–506.
- 59Pendergast LL, Youngstrom EA, Merkitch KG et al. Differentiating bipolar disorder from unipolar depression and ADHD: the utility of the General Behavior Inventory. Psychol Assess 2014; 26: 195–206.
- 60Horwitz SM, Demeter CA, Pagano ME et al. Longitudinal Assessment of Manic Symptoms (LAMS) study: background, design, and initial screening results. J Clin Psychiatry 2010; 71: 1511–1517.
- 61Findling RL, Youngstrom EA, Fristad MA et al. Characteristics of children with elevated symptoms of mania: the Longitudinal Assessment of Manic Symptoms (LAMS) study. J Clin Psychiatry 2010; 71: 1664–1672.
- 62Youngstrom EA, Frazier TW, Demeter C, Calabrese JR, Findling RL. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry 2008; 69: 831–839.
- 63Findling RL, Jo B, Frazier TW, Youngstrom EA et al. The 24-month course of manic symptoms in children. Bipolar Disord 2013; 15: 669–679.
- 64Achenbach TM. Integrative Guide to the 1991 CBCL/4-18, YSR, and TRF Profiles. Burlington, VT: University of Vermont, Department of Psychology, 1991.
- 65Ayer L, Althoff R, Ivanova M et al. Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome. J Child Psychol Psychiatry 2009; 50: 1291–1300.
- 66Biederman J, Petty CR, Monuteaux MC et al. The Child Behavior Checklist-Pediatric Bipolar Disorder profile predicts a subsequent diagnosis of bipolar disorder and associated impairments in ADHD youth growing up: a longitudinal analysis. J Clin Psychiatry 2009; 70: 732–740.
- 67Diler RS, Birmaher B, Axelson D et al. The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder. J Child Adolesc Psychopharmacol 2009; 19: 23–30.
- 68Holtmann M, Buchmann AF, Esser G, Schmidt MH, Banaschewski T, Laucht M. The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. J Child Psychol Psychiatry 2011; 52: 139–147.
- 69Meyer SE, Carlson GA, Youngstrom E et al. Long-term outcomes of youth who manifested the CBCL-pediatric bipolar disorder phenotype during childhood and/or adolescence. J Affect Disord 2009; 113: 227–235.
- 70Volk HE, Todd RD. Does the Child Behavior Checklist juvenile bipolar disorder phenotype identify bipolar disorder? Biol Psychiatry 2007; 62: 115–120.
- 71Youngstrom E, Youngstrom JK, Starr M. Bipolar diagnoses in community mental health: Achenbach Child Behavior Checklist profiles and patterns of comorbidity. Biol Psychiatry 2005; 58: 569–575.
- 72Haslam N. Categorical versus dimensional models of mental disorder: the taxometric evidence. Aust N Z J Psychiatry 2003; 37: 696–704.
- 73Prisciandaro JJ, Roberts JE. A comparison of the predictive abilities of dimensional and categorical models of unipolar depression in the National Comorbidity Survey. Psychol Med 2009; 39: 1087–1096.
- 74Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978; 133: 429–435.
- 75Miller TJ, McGlashan TH, Rosen JL et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry 2002; 159: 863–865.
- 76Yung AR, Phillips LJ, McGorry PD et al. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry Suppl 1998; 172: 14–20.
- 77Schultze-Lutter F, Ruhrmann S, Klosterkoetter J. Can schizophrenia be predicted phenomenologically? In: JO Johannessen, B Martindale, J Cullberg eds. Evolving Psychosis, Different Stages, Different Treatments. London, New York, NY: Routledge, 2006: 104–123.
- 78Geller B, Zimerman B, Williams M et al. Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections. J Am Acad Child Adolesc Psychiatry 2001; 40: 450–455.
- 79First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV–Clinical Version (SCID-I/CV). Washington, DC: American Psychiatric Press, 1997.
- 80Kaufman J, Birmaher B, Rao U et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36: 980–988.
- 81Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–389.
- 82Kochman FJ, Hantouche EG, Ferrari P, Lancrenon S, Bayart D, Akiskal HS. Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder. J Affect Disord 2005; 85: 181–189.
- 83Akiskal HS, Akiskal KK, Haykal RF, Manning JS, Connor PD. TEMPS-A: progress towards validation of a self-rated clinical version of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire. J Affect Disord 2005; 85: 3–16.
- 84Nunnally JC, Bernstein LH. Psychometric Theory. New York, NY: McGraw-Hill, 1994.
- 85Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess 2003; 80: 99–103.
- 86Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979; 86: 420–428.
- 87Ozgürdal S, van Haren E, Hauser M et al. Early mood swings as symptoms of the bipolar prodrome: preliminary results of a retrospective analysis. Psychopathology 2009; 42: 337–342.
- 88Lewinsohn PM, Klein DN, Seeley JR. Bipolar disorder during adolescence and young adulthood in a community sample. Bipolar Disord 2000; 2: 281–293.
- 89Geller B, Cooper TB, Zimerman B et al. Lithium for prepubertal depressed children with family history predictors of future bipolarity: a double-blind, placebo-controlled study. J Affect Disord 1998; 51: 165–175.
- 90Chang KD, Dienes K, Blasey C, Adleman N, Ketter T, Steiner H. Divalproex monotherapy in the treatment of bipolar offspring with mood and behavioral disorders and at least mild affective symptoms. J Clin Psychiatry 2003; 64: 936–942.
