The CBCL as a screen for psychiatric comorbidity in paediatric patients with ADHD
- 1Pediatric Psychopharmacology Research Program, Massachusetts General Hospital, Boston, MA, USA
- 2Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
- 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;
- Accepted 2 May 2005
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.
- 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
Dr Stephen V Faraone receives research support from the following sources: McNeil Consumer & Specialty Pharmaceuticals, Shire Laboratories, Eli Lilly & Company, the National Institute of Mental Health, The National Institute of Child Health and Development, and the National Institute of Neurological Diseases and Stroke. He is a speaker for the following speaker’s bureaus: Eli Lilly & Company, McNeil Consumer & Specialty Pharmaceuticals, and Shire Laboratories. He has had an advisory or consulting relationship with the following pharmaceutical companies: McNeil Consumer & Specialty Pharmaceuticals, Noven Pharmaceuticals, Shire Laboratories, and Eli Lilly & Company.
Funding: this work was supported, in part, by USPHS (NIMH) grant R01MH-41314 (JB)
Competing interests: Dr Joseph Biederman receives research support from the following sources: Shire Laboratories, Inc and Eli Lilly & Company, Pfizer Pharmaceutical, Cephalon Pharmaceutical, Janssen Pharaceutical, Neurosearch. Pharmaceuticals, Stanley Medical Institute, Lilly Foundation, Prechter Foundation, NIMH, NICHD, and NIDA. He is a speaker for the following speaker’s bureaus: Eli Lilly & Company, Pfizer Pharmaceutical, Novartis Pharmaceutical, Wyeth Ayerst, Shire Laboratories Inc., McNeil Pharmaceutical, and Cephalon Pharmaceutical. He is on the advisory board for the following pharmaceutical companies: Eli Lilly & Company, CellTech, Shire Laboratories Inc., Novartis Pharmaceutical, Noven Pharmaceutical, McNeil Pharmaceuticals, Janssen, Johnson & Johnson, Pfizer, and Cephalon Pharmaceuticals.