Improving Clinical Prediction of Bipolar Spectrum Disorders in Youth
Identifieur interne : 002807 ( Main/Exploration ); précédent : 002806; suivant : 002808Improving Clinical Prediction of Bipolar Spectrum Disorders in Youth
Auteurs : Thomas W. Frazier [États-Unis] ; Eric A. Youngstrom ; Mary A. Fristad ; Christine Demeter ; Boris Birmaher ; Robert A. Kowatch ; L. Eugene Arnold ; David Axelson ; Mary K. Gill ; Sarah M. Horwitz ; Robert L. FindlingSource :
- Journal of Clinical Medicine [ 2077-0383 ] ; 2014.
Abstract
This report evaluates whether classification tree algorithms (CTA) may improve the identification of individuals at risk for bipolar spectrum disorders (BPSD). Analyses used the Longitudinal Assessment of Manic Symptoms (LAMS) cohort (629 youth, 148 with BPSD and 481 without BPSD). Parent ratings of mania symptoms, stressful life events, parenting stress, and parental history of mania were included as risk factors. Comparable overall accuracy was observed for CTA (75.4%) relative to logistic regression (77.6%). However, CTA showed increased sensitivity (0.28
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DOI: 10.3390/jcm3010218
PubMed: 25143826
PubMed Central: 4136460
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Improving Clinical Prediction of Bipolar Spectrum Disorders in Youth</title><author><name sortKey="Frazier, Thomas W" sort="Frazier, Thomas W" uniqKey="Frazier T" first="Thomas W." last="Frazier">Thomas W. Frazier</name><affiliation wicri:level="2"><nlm:aff id="af1-jcm-03-00218">Center for Autism, Cleveland Clinic, Cleveland, OH 44104, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Autism, Cleveland Clinic, Cleveland, OH 44104</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Youngstrom, Eric A" sort="Youngstrom, Eric A" uniqKey="Youngstrom E" first="Eric A." last="Youngstrom">Eric A. Youngstrom</name><affiliation><nlm:aff id="af2-jcm-03-00218">Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; E-Mail:<email>eay@unc.edu</email></nlm:aff></affiliation></author><author><name sortKey="Fristad, Mary A" sort="Fristad, Mary A" uniqKey="Fristad M" first="Mary A." last="Fristad">Mary A. Fristad</name><affiliation><nlm:aff id="af3-jcm-03-00218">Department of Psychiatry, Division of Child and Adolescent Psychiatry, Ohio State University, Columbus, OH 43210, USA; E-Mails:<email>mary.fristad@osumc.edu</email> (M.A.F.);<email>l.arnold@osumc.edu</email> (L.E.A.)</nlm:aff></affiliation></author><author><name sortKey="Demeter, Christine" sort="Demeter, Christine" uniqKey="Demeter C" first="Christine" last="Demeter">Christine Demeter</name><affiliation><nlm:aff id="af4-jcm-03-00218">Department of Psychiatry, Division of Child and Adolescent Psychiatry, University Hospitals Case Medical Center, Cleveland, OH 44106, USA; E-Mail:<email>christine.demeter@uhhospitals.org</email></nlm:aff></affiliation></author><author><name sortKey="Birmaher, Boris" sort="Birmaher, Boris" uniqKey="Birmaher B" first="Boris" last="Birmaher">Boris Birmaher</name><affiliation><nlm:aff id="af5-jcm-03-00218">Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; E-Mails:<email>birmaherb@upmc.edu</email> (B.B.);<email>axelsonda@upmc.edu</email> (D.A.);<email>gillmk@upmc.edu</email> (M.K.G.)</nlm:aff></affiliation></author><author><name sortKey="Kowatch, Robert A" sort="Kowatch, Robert A" uniqKey="Kowatch R" first="Robert A." last="Kowatch">Robert A. Kowatch</name><affiliation><nlm:aff id="af6-jcm-03-00218">Department of Psychiatry, Nationwide Children’s Hospital, Columbus, OH 4320, USA; E-Mail:<email>robert.kowatch@nationwidechildrens.org</email></nlm:aff></affiliation></author><author><name sortKey="Arnold, L Eugene" sort="Arnold, L Eugene" uniqKey="Arnold L" first="L. Eugene" last="Arnold">L. Eugene Arnold</name><affiliation><nlm:aff id="af3-jcm-03-00218">Department of Psychiatry, Division of Child and Adolescent Psychiatry, Ohio State University, Columbus, OH 43210, USA; E-Mails:<email>mary.fristad@osumc.edu</email> (M.A.F.);<email>l.arnold@osumc.edu</email> (L.E.A.)</nlm:aff></affiliation></author><author><name sortKey="Axelson, David" sort="Axelson, David" uniqKey="Axelson D" first="David" last="Axelson">David Axelson</name><affiliation><nlm:aff id="af5-jcm-03-00218">Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; E-Mails:<email>birmaherb@upmc.edu</email> (B.B.);<email>axelsonda@upmc.edu</email> (D.A.);<email>gillmk@upmc.edu</email> (M.K.G.)</nlm:aff></affiliation></author><author><name sortKey="Gill, Mary K" sort="Gill, Mary K" uniqKey="Gill M" first="Mary K." last="Gill">Mary K. Gill</name><affiliation><nlm:aff id="af5-jcm-03-00218">Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; E-Mails:<email>birmaherb@upmc.edu</email> (B.B.);<email>axelsonda@upmc.edu</email> (D.A.);<email>gillmk@upmc.edu</email> (M.K.G.)</nlm:aff></affiliation></author><author><name sortKey="Horwitz, Sarah M" sort="Horwitz, Sarah M" uniqKey="Horwitz S" first="Sarah M." last="Horwitz">Sarah M. Horwitz</name><affiliation><nlm:aff id="af7-jcm-03-00218">Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA; E-Mail:<email>sarah.horwitz@nyumc.org</email></nlm:aff></affiliation></author><author><name sortKey="Findling, Robert L" sort="Findling, Robert L" uniqKey="Findling R" first="Robert L." last="Findling">Robert L. Findling</name><affiliation><nlm:aff id="af8-jcm-03-00218">Department of Psychiatry, Johns Hopkins University, Baltimore, MD 21287, USA; E-Mail:<email>rfindli1@jhmi.edu</email></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25143826</idno><idno type="pmc">4136460</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4136460</idno><idno type="RBID">PMC:4136460</idno><idno type="doi">10.3390/jcm3010218</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000135</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000135</idno><idno type="wicri:Area/Pmc/Curation">000135</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000135</idno><idno type="wicri:Area/Pmc/Checkpoint">001001</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001001</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">004216</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">004216</idno><idno type="wicri:Area/PubMed/Curation">004178</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">004178</idno><idno type="wicri:Area/PubMed/Checkpoint">004178</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">004178</idno><idno type="wicri:Area/Ncbi/Merge">003081</idno><idno type="wicri:Area/Ncbi/Curation">003081</idno><idno type="wicri:Area/Ncbi/Checkpoint">003081</idno><idno type="wicri:Area/Main/Merge">002922</idno><idno type="wicri:Area/Main/Curation">002807</idno><idno type="wicri:Area/Main/Exploration">002807</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Improving Clinical Prediction of Bipolar Spectrum Disorders in Youth</title><author><name sortKey="Frazier, Thomas W" sort="Frazier, Thomas W" uniqKey="Frazier T" first="Thomas W." last="Frazier">Thomas W. Frazier</name><affiliation wicri:level="2"><nlm:aff id="af1-jcm-03-00218">Center for Autism, Cleveland Clinic, Cleveland, OH 44104, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Autism, Cleveland Clinic, Cleveland, OH 44104</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Youngstrom, Eric A" sort="Youngstrom, Eric A" uniqKey="Youngstrom E" first="Eric A." last="Youngstrom">Eric A. Youngstrom</name><affiliation><nlm:aff id="af2-jcm-03-00218">Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; E-Mail:<email>eay@unc.edu</email></nlm:aff></affiliation></author><author><name sortKey="Fristad, Mary A" sort="Fristad, Mary A" uniqKey="Fristad M" first="Mary A." last="Fristad">Mary A. Fristad</name><affiliation><nlm:aff id="af3-jcm-03-00218">Department of Psychiatry, Division of Child and Adolescent Psychiatry, Ohio State University, Columbus, OH 43210, USA; E-Mails:<email>mary.fristad@osumc.edu</email> (M.A.F.);<email>l.arnold@osumc.edu</email> (L.E.A.)</nlm:aff></affiliation></author><author><name sortKey="Demeter, Christine" sort="Demeter, Christine" uniqKey="Demeter C" first="Christine" last="Demeter">Christine Demeter</name><affiliation><nlm:aff id="af4-jcm-03-00218">Department of Psychiatry, Division of Child and Adolescent Psychiatry, University Hospitals Case Medical Center, Cleveland, OH 44106, USA; E-Mail:<email>christine.demeter@uhhospitals.org</email></nlm:aff></affiliation></author><author><name sortKey="Birmaher, Boris" sort="Birmaher, Boris" uniqKey="Birmaher B" first="Boris" last="Birmaher">Boris Birmaher</name><affiliation><nlm:aff id="af5-jcm-03-00218">Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; E-Mails:<email>birmaherb@upmc.edu</email> (B.B.);<email>axelsonda@upmc.edu</email> (D.A.);<email>gillmk@upmc.edu</email> (M.K.G.)</nlm:aff></affiliation></author><author><name sortKey="Kowatch, Robert A" sort="Kowatch, Robert A" uniqKey="Kowatch R" first="Robert A." last="Kowatch">Robert A. Kowatch</name><affiliation><nlm:aff id="af6-jcm-03-00218">Department of Psychiatry, Nationwide Children’s Hospital, Columbus, OH 4320, USA; E-Mail:<email>robert.kowatch@nationwidechildrens.org</email></nlm:aff></affiliation></author><author><name sortKey="Arnold, L Eugene" sort="Arnold, L Eugene" uniqKey="Arnold L" first="L. Eugene" last="Arnold">L. Eugene Arnold</name><affiliation><nlm:aff id="af3-jcm-03-00218">Department of Psychiatry, Division of Child and Adolescent Psychiatry, Ohio State University, Columbus, OH 43210, USA; E-Mails:<email>mary.fristad@osumc.edu</email> (M.A.F.);<email>l.arnold@osumc.edu</email> (L.E.A.)</nlm:aff></affiliation></author><author><name sortKey="Axelson, David" sort="Axelson, David" uniqKey="Axelson D" first="David" last="Axelson">David Axelson</name><affiliation><nlm:aff id="af5-jcm-03-00218">Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; E-Mails:<email>birmaherb@upmc.edu</email> (B.B.);<email>axelsonda@upmc.edu</email> (D.A.);<email>gillmk@upmc.edu</email> (M.K.G.)</nlm:aff></affiliation></author><author><name sortKey="Gill, Mary K" sort="Gill, Mary K" uniqKey="Gill M" first="Mary K." last="Gill">Mary K. Gill</name><affiliation><nlm:aff id="af5-jcm-03-00218">Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; E-Mails:<email>birmaherb@upmc.edu</email> (B.B.);<email>axelsonda@upmc.edu</email> (D.A.);<email>gillmk@upmc.edu</email> (M.K.G.)</nlm:aff></affiliation></author><author><name sortKey="Horwitz, Sarah M" sort="Horwitz, Sarah M" uniqKey="Horwitz S" first="Sarah M." last="Horwitz">Sarah M. Horwitz</name><affiliation><nlm:aff id="af7-jcm-03-00218">Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA; E-Mail:<email>sarah.horwitz@nyumc.org</email></nlm:aff></affiliation></author><author><name sortKey="Findling, Robert L" sort="Findling, Robert L" uniqKey="Findling R" first="Robert L." last="Findling">Robert L. Findling</name><affiliation><nlm:aff id="af8-jcm-03-00218">Department of Psychiatry, Johns Hopkins University, Baltimore, MD 21287, USA; E-Mail:<email>rfindli1@jhmi.edu</email></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Clinical Medicine</title><idno type="eISSN">2077-0383</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>This report evaluates whether classification tree algorithms (CTA) may improve the identification of individuals at risk for bipolar spectrum disorders (BPSD). Analyses used the Longitudinal Assessment of Manic Symptoms (LAMS) cohort (629 youth, 148 with BPSD and 481 without BPSD). Parent ratings of mania symptoms, stressful life events, parenting stress, and parental history of mania were included as risk factors. Comparable overall accuracy was observed for CTA (75.4%) relative to logistic regression (77.6%). However, CTA showed increased sensitivity (0.28 <italic>vs</italic>. 0.18) at the expense of slightly decreased specificity and positive predictive power. The advantage of CTA algorithms for clinical decision making is demonstrated by the combinations of predictors most useful for altering the probability of BPSD. The 24% sample probability of BPSD was substantially decreased in youth with low screening and baseline parent ratings of mania, negative parental history of mania, and low levels of stressful life events (2%). High screening plus high baseline parent-rated mania nearly doubled the BPSD probability (46%). Future work will benefit from examining additional, powerful predictors, such as alternative data sources (e.g., clinician ratings, neurocognitive test data); these may increase the clinical utility of CTA models further.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kraemer, H C" uniqKey="Kraemer H">H.C. Kraemer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fristad, M A" uniqKey="Fristad M">M.A. Fristad</name></author><author><name sortKey="Frazier, T W" uniqKey="Frazier T">T.W. Frazier</name></author><author><name sortKey="Youngstrom, E A" uniqKey="Youngstrom E">E.A. Youngstrom</name></author><author><name sortKey="Mount, K" uniqKey="Mount K">K. Mount</name></author><author><name sortKey="Fields, B W" uniqKey="Fields B">B.W. Fields</name></author><author><name sortKey="Demeter, C" uniqKey="Demeter C">C. Demeter</name></author><author><name sortKey="Birmaher, B" uniqKey="Birmaher B">B. 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Eugene Arnold</name><name sortKey="Axelson, David" sort="Axelson, David" uniqKey="Axelson D" first="David" last="Axelson">David Axelson</name><name sortKey="Birmaher, Boris" sort="Birmaher, Boris" uniqKey="Birmaher B" first="Boris" last="Birmaher">Boris Birmaher</name><name sortKey="Demeter, Christine" sort="Demeter, Christine" uniqKey="Demeter C" first="Christine" last="Demeter">Christine Demeter</name><name sortKey="Findling, Robert L" sort="Findling, Robert L" uniqKey="Findling R" first="Robert L." last="Findling">Robert L. Findling</name><name sortKey="Fristad, Mary A" sort="Fristad, Mary A" uniqKey="Fristad M" first="Mary A." last="Fristad">Mary A. Fristad</name><name sortKey="Gill, Mary K" sort="Gill, Mary K" uniqKey="Gill M" first="Mary K." last="Gill">Mary K. Gill</name><name sortKey="Horwitz, Sarah M" sort="Horwitz, Sarah M" uniqKey="Horwitz S" first="Sarah M." last="Horwitz">Sarah M. Horwitz</name><name sortKey="Kowatch, Robert A" sort="Kowatch, Robert A" uniqKey="Kowatch R" first="Robert A." last="Kowatch">Robert A. Kowatch</name><name sortKey="Youngstrom, Eric A" sort="Youngstrom, Eric A" uniqKey="Youngstrom E" first="Eric A." last="Youngstrom">Eric A. Youngstrom</name></noCountry><country name="États-Unis"><region name="Ohio"><name sortKey="Frazier, Thomas W" sort="Frazier, Thomas W" uniqKey="Frazier T" first="Thomas W." last="Frazier">Thomas W. Frazier</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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