Concurrent medical conditions with pediatric bipolar disorder.

PURPOSE OF REVIEW: Pediatric bipolar disorder is a serious mental illness with significant morbidity and mortality. A variety of medical and psychiatric conditions occur concurrently with bipolar disorder. These conditions have been more frequently reported in adults. There prevalence in pediatric bipolar disorder is less known. This report is particularly relevant and timely due to the chronic nature of bipolar disorder and the profound impact on health that its treatments can bring. This evolving area needs to be understood to maximize clinical outcomes. RECENT FINDINGS: While little has been published about pediatric bipolar disorder and its concurrent medical conditions specifically, many reports that focused on adults included pediatric subjects. Concurrent medical conditions fall into a small number of groupings. (1) Those that are related to bipolar disorder or its treatment. (2) Medical conditions that mimic mania. (3) Conditions that occur more commonly in patients with bipolar disorder, but do not appear to be related to its treatment. (4) Those that may be related to risk behaviors associated with bipolar disorder. SUMMARY: Many medical conditions that occur concurrently with bipolar disorder in adults are also present in youth. The premature (iatrogenic) initiation of some conditions related to its treatment may pose specific ethical dilemmas for those treating psychiatric conditions.

The Inventory of Suicide Orientation-30: further validation with adolescent psychiatric inpatients.

The present study examined the construct validity of the Inventory of Suicide Orientation-30 (ISO-30; King & Kowalchuk, 1994) with a sample of adolescent psychiatric inpatients. The ISO-30 is designed to assess five dimensions of risk factors related to suicide: hopelessness, suicide ideation, low self-esteem, inability to cope with emotions, and social isolation and withdrawal. Participants included 202 psychiatric hospitalized (106 boys, 96 girls) adolescents, ages 14 to 17 years. Confirmatory factor analyses provided support for the fit of the original five-factor oblique model. Reliability estimates of the study measures were adequate. Evidence of discriminant, convergent, and incremental validity estimates of the ISO-30 were strong. Contributions and limitations of the present findings are discussed.

A preliminary validation of the Positive and Negative Suicide Ideation (PANSI) inventory with normal adolescent samples.

The present study evaluated the factor structure, reliability, and validity of the Positive and Negative Suicide Ideation (PANSI; Osman, Gutierrez, Kopper, Barrios, & Chiros, 1998) inventory in a sample of high-school youths. The PANSI is designed as a measure of risk and protective factors related to suicidal behavior. Participants (114 boys and 103 girls) completed the PANSI and other self-report instruments. Results of the confirmatory factor analyses supported adequate fit of the 2-factor oblique model to the sample data. Both factor scales attained adequate levels of reliability. Boys and girls did not differ in their responses to the PANSI scales. The PANSI scale scores were associated with scores from related measures. Logistic-regression analyses were used to evaluate the contributions of the PANSI scale scores to differentiate between the study groups. Receiver Operating Characteristic (ROC) analyses, using data from the psychiatric suicide risk and high-school control youths, were used to identify cutoff scores of 1.63 and 3.33 for the PANSI-negative and PANSI-positive scales, respectively.

The Positive and Negative Suicide Ideation (PANSI) inventory: psychometric evaluation with adolescent psychiatric inpatient samples.

In this study, we evaluated the factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory (Osman, Gutierrez, Kopper, Barrios, & Chiros, 1998) using confirmatory factor analysis (CFA). The PANSI assesses the frequency of negative risk and protective factors that are related to suicidal behavior. Participants (n = 195) were adolescent psychiatric inpatients, ages 14 to 17 years, in the CFA. Results of the CFA supported the fit for the 2-factor oblique model as the best fitting model. The internal consistency reliability estimates of the 2 subscales, the PANSI-Negative (alpha = .96) and the PANSI-Positive (alpha = .89) were high. Scores on the PANSI scales differentiated between suicide attempters and controls and those at severe risk for suicide and controls. Correlational analyses provide strong support for the concurrent validity of the scales. The results of the logistic regression analyses provide support for the use of this new inventory as a risk measure of suicide-related behaviors: Scores on the PANSI scales (n = 54) also showed satisfactory evidence for test-retest reliability over a 2-week period.