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CASE PSYCHOLOGIST TO DEVELOP DIAGNOSTIC TOOL FOR DETECTING BIPOLAR DISORDER IN YOUNG CHILDREN
This new tool also has the potential to provide urban community mental health centers with an efficient and economical way to assess the disorder for families seeking help for their children. Eric Youngstrom He will work with Robert Findling, CWRU associate professor of psychiatry, and Joseph Calabrese, Case professor of medicine, from the Stanley Medical Research Institute for Bipolar Disorder across the Life Span at University Hospitals of Cleveland and Jen Youngstrom, a child psychologist from Applewood Centers Inc. in Cleveland and Case adjunct assistant professor of psychology. Bipolar disorder in its extreme form is characterized by deep depression and high energy, out-of-control episodes or a combination of the two extremes that can last for weeks or months. Left untreated, the disorder's episodes become more frequent and more resistant to change through medications and behavioral interventions. The World Health Organization has described it as the leading causes of death and disabilities among mental health disorders. Youngstrom says that those with bipolar disorder are at risk for substance abuse, problems with the law and suicide. The disease also has a genetic link and appears in its most severe form in about two percent of the adult population. The numbers for children are unknown, says Youngstrom. "The diagnosis of bipolar disorder in children and adolescents is very controversial right now and unfortunately it is a high-stakes decision," says Youngstrom. When children are misdiagnosed, they can have life-threatening side effect from the wrong, which may further exacerbate their mental health welfare. "Like attention deficit disorders diagnoses, which were trendy 15 years ago, bipolar disorder has become the fad diagnosis," he states. "We probably only know about a tenth of the information about bipolar disorder in children than we do about it in adults. Most of that information is based on diagnosis of children from white, middle class backgrounds," Youngstrom explains. Diagnosing bipolar disorder in children has divided the psychological community into two camps, says Youngstrom. One group feels the onset of the disorder appears in the late teens and early 20s, while the other group believes it is happening more often than realized in children, and symptoms, such as irritability and aggression, can be exhibited in children as young as two years old. The study should provide information the psychological community needs. Over the next five year, the study will undergo three phases. In the first four years of the study, 600 low-income families visiting the Applewood Centers will participate in a five-hour interview. Children and parents will answer questions that may help identify not only bipolar disorder but also a number of other disorders. Researchers will gather more than 400 pages of data per family in order to test diagnostic assessments developed at University Hospitals and used in diagnosing primarily middle-class, white children. "This phase of the study is the first step to bring state-of-the-art mental health assessment to under-served communities," says Youngstrom. During the fifth year of the study and the second phase, researchers will streamline the interview process to 30 questions they have found most useful in the diagnostic process and give this assessment to as many as 800 families visiting Applewood that year. From those families, the 35 families that exceeded and 35 that fell below the screen will undergo the intensive 400-page information gathering sessions. In the final part of the study, researchers will return to University Hospital to develop the next generation of the diagnostic tool. This tool will be tested on more than 200 new families visiting the hospital's psychiatric department and will address key symptoms to help distinguish bipolar disorder from other conditions like attention deficit disorder and conduct disorder. "It is my hope that this project will enable clinicians to recognize the condition more accurately, diagnose it earlier and increase the services delivered to an underserved population," says Youngstrom.
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