An inexpensive family index of risk for mood issues improves identification of pediatric bipolar disorder

Area of Science:

• Child and Adolescent Psychiatry
• Mental Health Assessment
• Clinical Psychology

Background:

• Family history is crucial for diagnosing pediatric bipolar disorder (PBD).
• Current methods for collecting family history in clinical settings are often challenging and time-consuming.
• Developing practical and inexpensive tools is essential for improving PBD detection.

Purpose of the Study:

• To assess the feasibility and utility of the Family Index of Risk for Mood issues (FIRM) for gathering family history in pediatric outpatient clinics.
• To determine if FIRM scores can effectively discriminate PBD cases from other diagnoses.
• To evaluate the FIRM's contribution to PBD detection beyond standard rating scales.

Main Methods:

• A total of 273 families with children aged 5-18 presenting to an outpatient clinic participated.
• Primary caregivers completed the half-page FIRM questionnaire.
• Diagnostic assessments included the Mini-International Neuropsychiatric Interview and the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children.

Main Results:

• The FIRM was completed quickly and easily by all families.
• 78% of families reported at least one relative with a history of mood or substance issues.
• FIRM scores effectively discriminated PBD cases from other diagnoses (AUROC=.63, p=.006) and improved PBD detection when controlling for rating scales.

Conclusions:

• The FIRM is an inexpensive and clinically practical tool for gathering family history information in pediatric mental health settings.
• Family history, as assessed by the FIRM, demonstrates clinically meaningful discrimination of PBD.
• This method can enhance the early detection and diagnosis of pediatric bipolar disorder.