DEVELOPMENT OF MANIA RATING SCALES FOR CHILDREN AGE 6-12

这项拟议的研究的重点是开发双相情感评估工具 青春期前儿童的疾病。就像双相情感障碍直到最近 在青春期前被认为是一种合法的精神障碍 人口评估工具有限。这一点意义重大 对提供常规评估的临床医生和 对双相情感障碍儿童的管理，以及试图 为这些疾病确定最合适的治疗类型和强度 孩子们。这种疾病的诊断不足已被记录在 孩子们。Weller等人的研究成果。报告称，50%的儿童被诊断为 躁狂症的研究最初得到了一些其他诊断，最常见的是 精神分裂症。他们强调有必要考虑狂热在 精神病儿童的尊重诊断(1986a)。进行的研究 迄今为止，关于双相情感障碍儿童的研究以缺乏系统性而著称 行为观察。因此，如果没有有效和可靠的工具来 评估儿童双相情感障碍，诊断的准确性， 关于心理健康的后续护理和研究的适当性 对双相情感障碍儿童的服务将受到阻碍。虽然 临床评定量表是评估和监测躁狂症的常用工具 在成年人口中，还没有开发出或测试过这样的量表 尤其是青春期前儿童。最有用的是，这样的天平 应该能够区分躁狂和多动症儿童，因为这 这是一种特别难做出的歧视。 因此，这项研究的目的是开发更精确的 评估青春期前儿童双相情感障碍的工具。这些 仪器的设计应使它们既可用于 对双相情感障碍儿童的常规管理和研究 向这些儿童提供服务的效果。要做到这一点， 遵循两个躁狂评定量表的心理测量学特征，躁狂 评定量表与临床总体印象--躁狂症 在青春期前人群中确定：最佳分界点分数， 敏感度，特异度，预测值，诊断信心， 对临床状态变化的敏感性，重测可靠性， 内部一致性、收敛效度和区分效度。 双相情感障碍儿童将在这些方面以及其他方面进行基线比较 对注意力缺陷儿童的先前验证的工具 单纯性多动障碍(ADHD)，ADHD和品行障碍，单相 严重抑郁、精神分裂症，并以正常儿童为对照。全 六个小组将在六周后接受重新评估。这项研究应该 提供有关信度、效度和实用性的基本数据 用两个评分表来评估躁狂。此信息应为 对心理健康服务提供者有利，因为他们评估、治疗和 研究儿童双相情感障碍的治疗效果。

The proposed study's focus is to develop assessment tools for bipolar illness in prepubertal children. As bipolar illness has only recently been recognized as a legitimate psychiatric disorder among a prepubertal population assessment instruments are limited. This is of significant concern, both to clinicians who provide routine evaluation and management of bipolar children, and to researchers attempting to determine the most appropriate type and intensity of treatment for these children. Underdiagnosis of the disorder has been documented in children. Weller, et al. reported 50% of children diagnosed in their study as manic originally received some other diagnosis, most commonly schizophrenia. They stress the need to consider mania in the deferential diagnosis of psychotic children (1986a). Research conducted to date on bipolar children is noted for its lack of systematic behavioral observations. Thus, without valid and reliable tools to assess bipolar illness in children, accuracy in diagnosis, appropriateness of subsequent care, and research regarding mental health services to children with bipolar disorder will be hindered. Although clinical rating scales to assess and monitor mania are commonly used with adult populations, no such scales have been developed for or tested specifically in prepubertal children. To be most useful, such scales should be able to discriminate manic from hyperactive children, as this is an especially difficult discrimination to make. Therefore, the purpose of this study is to develop more precise instruments to assess bipolar illness in prepubertal children. these instruments should be designed such that they can be used both in the regular management of bipolar children and in research to examine the efficacy of service delivery to these children. To accomplish this, the following psychometric properties of two mania rating scales, the Mania Rating Scale and the Clinical Global Impression--Mania will be determined in a prepubertal population: optimal cut-off scores, sensitivity, specificity, predictive value, diagnostic confidence, sensitivity to change in clinical status, test-retest reliability, internal consistency, convergent validity, and discriminant validity. Bipolar children will be compared at baseline on these as well as other previously validated instruments to children with attention deficit hyperactivity disorder (ADHD) alone, ADHD and conduct disorder, unipolar major depression, schizophrenia, and to normal control children. All six groups will be reassessed six weeks later. This study should provide essential data regarding the reliability, validity, and utility of two rating scales to assess mania. This information should be beneficial to mental health service providers as they assess, treat, and study treatment efficacy of bipolar illness in children.