Further Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis

Maura DiSalvo; Chloe Hutt Vater; Allison Green; K Yvonne Woodworth; Abigail Farrell; Joseph Biederman; Stephen Faraone

doi:10.2478/sjcapp-2023-0005

Further Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis

Scand J Child Adolesc Psychiatr Psychol. 2023 May 22;11(1):44-59. doi: 10.2478/sjcapp-2023-0005. eCollection 2023 Jan.

Authors

Maura DiSalvo¹, Chloe Hutt Vater¹, Allison Green^{1

2}, K Yvonne Woodworth¹, Abigail Farrell^{1

3}, Joseph Biederman^{1

4}, Stephen Faraone⁵

Affiliations

¹ Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States.
² Department of Psychological and Brain Sciences, Indiana University, Indiana, United States.
³ Department of Psychology, University of Houston, Houston, United States.
⁴ Boston Department of Psychiatry, Massachusetts General Hospital, Boston, United States.
⁵ Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, United States.

Abstract

Background: Previous research has found that a unique profile of the Child Behavior Checklist comprising of aggregate elevations of the Attention, Anxiety/Depression and Aggression scales (A-A-A profile, CBCL-Bipolar (BP) profile, CBCL-Dysregulation profile (DP); henceforth CBCL-BP/DP profile) is associated with a clinical diagnosis of pediatric bipolar (BP) disorder.

Objective: The main aim of the study is to evaluate the strength of the association between the CBCL-BP/DP profile and the clinical diagnosis of pediatric BP disorder through a meta-analysis.

Methods: A literature search was performed to identify studies that examined the association between a positive CBCL-BP/DP profile and a clinical diagnosis of pediatric BP disorder. The meta-analyses first examined studies assessing the rates of a positive CBCL-BP/DP profile in youth with BP disorder versus those with 1) ADHD, anxiety/depression, or disruptive behavior disorders (DBDs), and 2) non-bipolar controls. The second analysis evaluated studies examining the rates of pediatric BP disorder in youth with and without a positive CBCL-BP/DP profile.

Results: Eighteen articles met our inclusion and exclusion criteria, and fifteen articles had adequate data for meta-analysis. Results showed that BP youth were at significantly increased odds of having a positive CBCL-BP/DP profile compared to those with other psychiatric disorders (i.e., ADHD, anxiety/depression, or DBDs) (pooled OR=4.34, 95% CI=2.82, 8.27; p<0.001) and healthy control groups (pooled OR=34.77, 95% CI=2.87, 420.95; p=0.005). Further, meta-analysis results showed that youth with a positive CBCL-BP/DP profile were at significantly increased odds of having a BP disorder diagnosis compared to those without (pooled OR=4.25, 95% CI=2.12, 8.52; p<0.001).

Conclusion: Our systematic review and meta-analysis of the extant literature provides strong support for the association between the CBCL-BP/DP profile and pediatric BP disorder.

Keywords: Bipolar disorder; CBCL; Child Behavior Checklist; children; mood disorders; youth.

Abstract

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