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The CBCL as a screen for psychiatric comorbidity in paediatric patients with ADHD

¹ Pediatric Psychopharmacology Research Program, Massachusetts General Hospital, Boston, MA, USA
² Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA

Correspondence to:
Correspondence to:
Dr J Biederman
Massachusetts General Hospital, Pediatric Psychopharmacology Research Program, Yawkey Center for Patient Care-YAW-6A-6900, 32 Fruit Street, Boston, MA 02114, USA; jbiederman{at}partners.org

Aims: To examine the informativeness of the Child Behavior Checklist (CBCL) as a screening tool to identify comorbid and non-comorbid cases of attention deficit hyperactivity disorder (ADHD) in a paediatrically referred population. It was hypothesised that specific scales of the CBCL would help identify specific comorbidities within ADHD cases in the primary care setting.

Methods: The sample consisted of children and adolescents 6–17 years old of both genders with ADHD (n = 121). A receiver operating curve (ROC) approach was used to determine which CBCL scales best differentiated between ADHD cases with and without its comorbidities with conduct, anxiety, and mood disorders.

Results: ROC analysis showed that the CBCL Delinquent Behavior and Aggressive Behavior scales predicted the structured interview derived diagnoses of conduct and bipolar disorder, the Anxious/Depressed and Aggressive Behavior scales predicted major depression, and the Anxious/Depressed and Attention problems scales predicted anxiety disorders.

Conclusions: These results extend to a paediatrically referred population with previously reported findings in psychiatric samples documenting good convergence between structured interview diagnoses and syndrome congruent CBCL scales. These findings support the utility of the CBCL as a screening tool for the identification of psychiatric comorbidity in ADHD youth in the primary care setting.

Abbreviations: ADHD, attention deficit hyperactivity disorder; ANX, multiple anxiety disorder; AUC, area under the curve; BPD, bipolar disorder; CBCL, Child Behavior Checklist; CD, conduct disorder; MD, major depression; NPV, negative predictive value; PPV, positive predictive value; ROC, receiver operating characteristic

Keywords: ADHD; CBCL; comorbidity; paediatric; screening

Relevant Article

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Howard Bauchner
Arch. Dis. Child. 2005 90: 991a. [Extract] [Full Text] [PDF]

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