Prepubertal and young adolescent bipolarity versus ADHD: assessment and validity using the WASH-U-KSADS, CBCL and TRF

Background: This addendum to 'Prepubertal and early adolescent bipolarity d ifferentiate from ADHD by mania criteria; grandiose delusions; ultra-rapid or ultradian cycling' (in this volume) provides (1) a description of Washin gton University at St. Louis Kiddie Schedule for Affective Disorders and Sc hizophrenia (WASH-U-KSADS) with sample sections (hypersexuality, rapid cycl ing); (2) a comparison of WASH-U-KSADS to KSADS-P/L and KSADS-1986 and (3) a comparison of WASH-U-KSADS to Child Behavior Checklist (CBCL) and Teacher s Report Form (TRF) data. Methods: Data were from the first 60 bipolar (BP) and first 60 ADHD subjects of 270 consecutively ascertained cases (90 BP, 90 ADHD and 90 community controls) in the NIMH funded 'Phenomenology and Co urse of Pediatric Bipolarity' study. Comprehensive assessments included the WASH-U-KSADS (administered blindly to mothers and separately to children), CBCL and TRF. Results: As reported elsewhere in this volume, WASH-U-KSADS data significantly differentiated BP and ADHD groups. Significant differenc es were also found with the parent-rated CBCL and the teacher-rated TRF, th ereby providing cross-modality and cross-informant validation of the WASH-U -KSADS. Because of the close agreement with published CBCL data from anothe r investigator, cross-site validation also occurred. Limitations: Venues fo r consecutive ascertainment from the lowest socioeconomic status classes we re unavailable due to current health care policies. Clinical relevance: CBC L and TRF data separated BP from ADHD groups, largely by non-specific exter nalizing dimensions (e.g., hyperactivity, aggressivity). Clinically relevan t differentiation by categorical mania-specific criteria (e.g., elated mood , grandiosity, racing thoughts) occurred with WASH-U-KSADS data. Both types of data are crucial for genetic and neurobiological studies. (C) 1998 Else vier Science B.V. All rights reserved.